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人群药代动力学研究:MEK 抑制剂 selumetinib 及其活性 N-去甲基代谢物。来自 10 项 I 期临床试验的数据。

Population pharmacokinetics of the MEK inhibitor selumetinib and its active N-desmethyl metabolite: data from 10 phase I trials.

机构信息

Manchester Pharmacy School, Manchester, UK.

AstraZeneca, Alderley Park, Macclesfield, Cheshire, UK.

出版信息

Br J Clin Pharmacol. 2018 Jan;84(1):52-63. doi: 10.1111/bcp.13404. Epub 2017 Sep 22.

Abstract

AIMS

The aims of the study were to characterize the pharmacokinetics (PK) of selumetinib (AZD6244; ARRY-142886), a mitogen-activated protein kinase kinase (MEK) 1/2 inhibitor in clinical development for various indications, and its N-desmethyl metabolite in healthy volunteers, and evaluate clinically important covariates.

METHODS

A pooled-population PK analysis was performed using a nonlinear mixed-effects approach with plasma concentration data from 346 subjects who received single oral doses of selumetinib 20-75 mg across 10 phase I studies. Absolute bioavailability was determined using intravenous [ C] selumetinib.

RESULTS

A two-compartment linear model with sequential zero-first order absorption and a lag time for the zero-order process was described for selumetinib PK. N-desmethyl metabolite disposition was described by a single compartment with linear elimination, without back transformation. The parent-only and joint models generally described pooled data adequately. For the median subject, not taking interacting drugs, estimates for clearance (CL) and central volume of distribution (V2) for selumetinib in the final joint model were 12.7 l h and 35.6 l, respectively. Food effects, comedication with itraconazole [a cytochrome P450 (CYP) 3A4 inhibitor], fluconazole (a CYP2C19 inhibitor) and rifampicin (a CYP3A4 inducer) and formulation effects were incorporated into the base model a priori. Race and hepatic function were also influential in the PK model. Additional covariates affecting selumetinib disposition identified from covariate analysis were age on V2, bilirubin on CL, and weight on CL and V2.

CONCLUSIONS

Analysis confirmed previous clinical pharmacology study findings of drug-drug interactions and food effects, with additional covariates that influence selumetinib and N-desmethyl selumetinib PK identified. Dose modifications based on these additional covariates were not considered necessary.

摘要

目的

本研究旨在描述在研用于多种适应证的丝裂原活化蛋白激酶激酶(MEK)1/2 抑制剂 selumetinib(AZD6244;ARRY-142886)及其 N-去甲基代谢物在健康志愿者中的药代动力学(PK)特征,并评估具有临床重要意义的协变量。

方法

采用非线性混合效应模型对来自 10 项 I 期研究的 346 例接受单剂量 20-75mg 口服 selumetinib 的受试者的血浆浓度数据进行群体 PK 分析。采用静脉内[C]selumetinib 测定绝对生物利用度。

结果

selumetinib PK 采用两室线性模型描述,该模型具有顺序零级-一级吸收和零级过程的滞后时间。N-去甲基代谢物处置采用无反推的单室线性消除模型描述。仅母体药物模型和联合模型通常可充分描述合并数据。对于中位数受试者(未服用相互作用药物),最终联合模型中 selumetinib 的清除率(CL)和中央分布容积(V2)估计值分别为 12.7 l/h 和 35.6 l。食物效应、酮康唑(CYP3A4 抑制剂)、氟康唑(CYP2C19 抑制剂)和利福平(CYP3A4 诱导剂)合用以及制剂效应被预先纳入基础模型。种族和肝功能也是 PK 模型中的影响因素。从协变量分析中确定的影响 selumetinib 处置的其他协变量为 V2 上的年龄、CL 上的胆红素和 CL 和 V2 上的体重。

结论

分析结果证实了先前关于药物相互作用和食物效应的临床药理学研究发现,同时确定了影响 selumetinib 和 N-去甲基 selumetinib PK 的其他协变量。未考虑基于这些附加协变量进行剂量调整。

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