Childress Ann, Mehrotra Shailly, Gobburu Jogarao, McLean Angus, DeSousa Norberto J, Incledon Bev
1 The Center for Psychiatry and Behavioral Medicine , Las Vegas, Nevada.
2 Center for Translational Medicine, School of Pharmacy, University of Maryland , Baltimore, Maryland.
J Child Adolesc Psychopharmacol. 2018 Feb;28(1):10-18. doi: 10.1089/cap.2017.0044. Epub 2017 Oct 17.
Current extended-release (ER) formulations of psychostimulants used for treatment of attention-deficit/hyperactivity disorder (ADHD) provide an extended duration of ADHD symptom control; however, the onset of efficacy can be protracted and variable, leaving the early morning untreated. The primary objective was to characterize the single-dose pharmacokinetics and tolerability of HLD200, an evening-dosed, delayed-release (DR) and ER formulation of methylphenidate (MPH), in healthy adults and in adolescents and children with ADHD.
The pharmacokinetics and tolerability of a single, oral evening dose of HLD200 (54 mg) were evaluated in two single-center open-label studies: the first in healthy adults (n = 12) and the second in adolescents (n = 18) and children (n = 11) with ADHD. Primary pharmacokinetic endpoints were the rate and extent of MPH absorption (C and area under the curve [AUC]) and time to peak concentration (T). These parameters were calculated using noncompartmental analysis.
HLD200 produced a pharmacokinetic profile characterized by an 8- to 10-hour delay in MPH release, followed by a period of extended controlled release, resulting in an ascending absorption profile that coincided with the early morning and afternoon. Mean values (coefficient of variation [CV]%) of weight-adjusted pharmacokinetic parameters were similar in adults and in adolescents and children with ADHD: C ([ng/mL]/[mg/kg]) was 9.1 (35.2), 8.8 (34.5), and 7.4 (30.1); AUC ([ng · h/mL]/[mg/kg]) was 126.5 (35.5), 129.4 (34.8), and 129.7 (27.3); and T (hours) was 15.6 (11.1), 17.1 (14.5), and 17.7 (14.1), respectively. Intersubject variability in the mean time to achieve ascending plasma MPH concentrations of 2, 3, 4, and 5 ng/mL was low (CV: 7.8%-17.7%).
Evening-dosed HLD200 produces the intended DR and ER pharmacokinetic profile that provides a consistent predictable delay in initial MPH release until the early morning, followed by extended release across the day. The body weight-adjusted pharmacokinetics of HLD200 were similar between adults and adolescents and children with ADHD.
目前用于治疗注意力缺陷多动障碍(ADHD)的精神兴奋剂缓释(ER)制剂可延长ADHD症状控制的持续时间;然而,疗效的起效可能延迟且多变,导致清晨时段无法得到治疗。主要目的是在健康成人以及患有ADHD的青少年和儿童中,对晚间服用的哌甲酯(MPH)缓释(DR)和ER制剂HLD200的单剂量药代动力学和耐受性进行特征描述。
在两项单中心开放标签研究中评估单次口服晚间剂量的HLD200(54毫克)的药代动力学和耐受性:第一项研究针对健康成人(n = 12),第二项研究针对患有ADHD的青少年(n = 18)和儿童(n = 11)。主要药代动力学终点指标为MPH吸收速率和程度(Cmax和曲线下面积[AUC])以及达峰浓度时间(Tmax)。这些参数使用非房室分析方法进行计算。
HLD200呈现出一种药代动力学特征,即MPH释放延迟8至10小时,随后是一段延长的控释期,导致吸收曲线上升,与清晨和下午时段相吻合。体重校正的药代动力学参数平均值(变异系数[CV]%)在成人以及患有ADHD的青少年和儿童中相似:Cmax([纳克/毫升]/[毫克/千克])分别为9.1(35.2)、8.8(34.5)和7.4(30.1);AUC([纳克·小时/毫升]/[毫克/千克])分别为126.5(35.5)、129.4(34.8)和129.7(27.3);Tmax(小时)分别为15.6(11.1)、17.1(14.5)和17.7(14.1)。在达到血浆MPH浓度升为2、3、4和5纳克/毫升的平均时间方面,受试者间变异性较低(CV:7.8% - 17.7%)。
晚间服用的HLD200产生了预期的DR和ER药代动力学特征,在MPH初始释放方面提供了一致且可预测的延迟,直至清晨,随后全天持续释放。HLD200在成人以及患有ADHD的青少年和儿童中,经体重校正后的药代动力学相似。