Kim Choon Ok, Oh Eun Sil, Kim Hohyun, Park Min Soo
Department of Clinical Pharmacology, Severance Hospital, Yonsei University College of Medicine, Seoul.
Department of Pharmaceutical Medicine and Regulatory Sciences, College of Medicine and Pharmacy, Yonsei University, Incheon.
Drug Des Devel Ther. 2017 Feb 23;11:503-512. doi: 10.2147/DDDT.S129586. eCollection 2017.
To improve cardiovascular outcomes, dyslipidemia in patients with diabetes needs to be treated. Thus, these patients are likely to take glimepiride and rosuvastatin concomitantly. Therefore, this study aimed to evaluate the pharmacokinetic (PK) interactions between these two drugs in healthy males and to explore the effect of and polymorphisms on their interactions in two randomized, open-label crossover studies. Glimepiride was studied in part 1 and rosuvastatin in part 2. Twenty-four participants were randomly assigned to each part. All subjects (n=24) completed part 1, and 22 subjects completed part 2. A total of 38 subjects among the participants of the PK interaction studies were enrolled in the genotype study to analyze their and polymorphisms retrospectively (n=22 in part 1, n=16 in part 2). Comparison of the PK and safety of each drug alone with those of the drugs in combination showed that both glimepiride and rosuvastatin did not interact with each other and had tolerable safety profiles in all subjects. However, with regard to glimepiride PK, the group had a significantly higher maximum plasma concentration (C) and area under the plasma concentration-time curve during the dose interval at steady state (AUC) for glimepiride in combination with rosuvastatin than those for glimepiride alone. However, other significant effects of the or polymorphism on the interaction between the two drugs were not observed. In conclusion, there were no significant PK interactions between the two drugs; however, the exposure to glimepiride could be affected by rosuvastatin in the presence of the polymorphism.
为改善心血管结局,糖尿病患者的血脂异常需要治疗。因此,这些患者可能会同时服用格列美脲和瑞舒伐他汀。所以,本研究旨在评估这两种药物在健康男性中的药代动力学(PK)相互作用,并在两项随机、开放标签的交叉研究中探讨CYP2C9和SLCO1B1基因多态性对它们相互作用的影响。在第1部分研究格列美脲,第2部分研究瑞舒伐他汀。每个部分随机分配24名参与者。所有受试者(n = 24)完成了第1部分,22名受试者完成了第2部分。PK相互作用研究的参与者中共有38名受试者被纳入基因研究,以回顾性分析他们的CYP2C9和SLCO1B1基因多态性(第1部分n = 22,第2部分n = 16)。将每种药物单独使用时的PK和安全性与联合用药时的情况进行比较,结果显示格列美脲和瑞舒伐他汀在所有受试者中均未相互作用,且具有可耐受的安全性。然而,就格列美脲的PK而言,在与瑞舒伐他汀联合使用时,CYP2C93组的格列美脲稳态剂量间隔期间的最大血浆浓度(Cmax)和血浆浓度-时间曲线下面积(AUC)显著高于单独使用格列美脲时。但是,未观察到CYP2C9或SLCO1B1基因多态性对这两种药物相互作用的其他显著影响。总之,这两种药物之间没有显著的PK相互作用;然而,在存在CYP2C93基因多态性的情况下,瑞舒伐他汀可能会影响格列美脲的暴露量。