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LY2623091在高血压和慢性肾脏病患者中的群体药代动力学

Population Pharmacokinetics of LY2623091 in Patients With Hypertension and Chronic Kidney Disease.

作者信息

Wang Evan B, Chaudhary Archana, Waterhouse Timothy H, Dickinson Gemma L

机构信息

Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

J Clin Pharmacol. 2017 Jun;57(6):739-746. doi: 10.1002/jcph.865. Epub 2017 Feb 1.

Abstract

LY2623091 is a selective, orally active, nonsteroidal, competitive mineralocorticoid receptor antagonist that blocks the actions of aldosterone and other mineralocorticoid receptor ligands at the receptor level. The aim of this work was to explore and establish a population pharmacokinetic model, quantify the degree of interindividual variability, and identify significant disease-, patient-, and study-specific covariates that alter the disposition of LY2623091. The data included concentrations from 294 healthy subjects and patients with hypertension and/or chronic kidney disease (CKD), sampled in 5 phase 1 and 2 studies. The pharmacokinetics of LY2623091 was well described by a 2-compartment model with first-order absorption and elimination. Formulation (on oral bioavailability) as well as weight and age (both on apparent central volume of distribution) were found to be significant covariates. The relative bioavailability of the capsule formulation was 68.4% compared to that of the solution. Hypertension and CKD status were not significant covariates. The pharmacokinetic model suggests that given the same dose, patients with hypertension and/or CKD would receive a similar exposure compared to subjects without these disease conditions.

摘要

LY2623091是一种选择性、口服活性、非甾体类竞争性盐皮质激素受体拮抗剂,可在受体水平阻断醛固酮及其他盐皮质激素受体配体的作用。本研究旨在探索并建立群体药代动力学模型,量化个体间变异性程度,并识别可改变LY2623091处置情况的显著疾病、患者及研究特异性协变量。数据来自5项1期和2期研究中采集的294名健康受试者以及高血压和/或慢性肾脏病(CKD)患者的血药浓度。LY2623091的药代动力学可用具有一级吸收和消除的二室模型很好地描述。发现剂型(对口服生物利用度)以及体重和年龄(均对表观中央分布容积)是显著协变量。胶囊剂型的相对生物利用度与溶液剂型相比为68.4%。高血压和CKD状态不是显著协变量。药代动力学模型表明,给予相同剂量时,高血压和/或CKD患者与无这些疾病状况的受试者相比,将接受相似的暴露量。

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