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健康受试者中普通感冒及合用鼻腔减充血剂对鼻用胰高血糖素的药代动力学和药效学的影响:一项随机临床试验。

Effects of common cold and concomitant administration of nasal decongestant on the pharmacokinetics and pharmacodynamics of nasal glucagon in otherwise healthy participants: A randomized clinical trial.

机构信息

Eli Lilly and Company, Indianapolis, Indiana.

Locemia Solutions, Montréal, Québec, Canada.

出版信息

Diabetes Obes Metab. 2018 Mar;20(3):646-653. doi: 10.1111/dom.13134. Epub 2017 Nov 19.

Abstract

AIMS

Nasal glucagon (NG) is a nasally-administered glucagon powder, absorbed through the nasal mucosa, designed for treatment of severe hypoglycaemia. This study evaluated the safety, pharmacokinetics (PK) and pharmacodynamics (PD) of NG in otherwise healthy participants with common colds and after recovery from cold symptoms, with and without concomitant nasal decongestant.

MATERIALS AND METHODS

This was a single-centre, open-label study. Cohort 1 participants (N = 18) received 2 doses of NG: one while experiencing nasal congestion and another after recovery from cold symptoms. Cohort 2 participants (N = 18), who also had colds with nasal congestion, received a single dose of NG 2 hours after treatment with the decongestant oxymetazoline. Total symptoms score and other safety measures were assessed before and after NG administration.

RESULTS

NG was well tolerated, without serious adverse events. Common adverse events (transient lacrimation, nasal discomfort, rhinorrhea and nausea) were more frequent in both Cohorts 1 and 2 during nasal congestion. Glucagon levels peaked 18 minutes post-dose and glucose levels peaked 30 to 42 minutes post-dose in all groups. Nasal congestion, with or without concomitant nasal decongestant, did not significantly affect PK of NG. Although glucose AUECs was different between Cohort 1 with nasal congestion and Cohort 2, glucose concentrations at 30 minutes appeared similar in all groups.

CONCLUSIONS

There were no clinically relevant differences in safety or PK/PD of NG associated with nasal congestion or concomitant administration of nasal decongestant, suggesting that NG can be used to treat severe hypoglycaemia in individuals experiencing nasal congestion.

摘要

目的

鼻用胰高血糖素(NG)是一种经鼻给药的胰高血糖素粉末,通过鼻腔黏膜吸收,用于治疗严重低血糖。本研究评估了鼻用 NG 在患有普通感冒以及在感冒症状消退后,无论是否同时使用鼻腔减充血剂,在健康参与者中的安全性、药代动力学(PK)和药效动力学(PD)。

材料和方法

这是一项单中心、开放标签研究。队列 1 参与者(N=18)接受了 2 剂 NG:一剂在出现鼻塞时,另一剂在感冒症状消退后。队列 2 参与者(N=18)也患有伴有鼻塞的感冒,在使用减充血剂羟甲唑啉治疗 2 小时后接受了单剂量 NG。在 NG 给药前后评估总症状评分和其他安全性措施。

结果

NG 耐受性良好,无严重不良事件。在队列 1 和 2 中,所有参与者在鼻塞时均更常出现常见不良事件(一过性流泪、鼻不适、流涕和恶心)。所有组中,NG 给药后 18 分钟时胰高血糖素水平达到峰值,葡萄糖水平在 30 至 42 分钟时达到峰值。鼻塞,无论是否同时使用鼻腔减充血剂,均未显著影响 NG 的 PK。尽管鼻塞的队列 1 和队列 2 之间的葡萄糖 AUEC 存在差异,但所有组在 30 分钟时的葡萄糖浓度似乎相似。

结论

与鼻塞或同时使用鼻腔减充血剂相关,NG 的安全性或 PK/PD 无临床相关差异,表明 NG 可用于治疗鼻塞患者的严重低血糖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5ad/5836949/1730eae29bdb/DOM-20-646-g001.jpg

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