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健康男性志愿者单次皮下注射两种促红细胞生成素α制剂Eporon和Eprex后的药代动力学和药效学比较

Comparable pharmacokinetics and pharmacodynamics of two epoetin alfa formulations Eporon and Eprex following a single subcutaneous administration in healthy male volunteers.

作者信息

Yoon Sumin, Rhee Su-Jin, Heo Sun Ju, Oh Tae Young, Yoon Seo Hyun, Cho Joo-Youn, Lee SeungHwan, Yu Kyung-Sang

机构信息

Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul.

Dong-A ST Co. Ltd., Seoul.

出版信息

Drug Des Devel Ther. 2017 Oct 27;11:3127-3135. doi: 10.2147/DDDT.S142673. eCollection 2017.

Abstract

PURPOSE

This study aimed to assess and compare the pharmacokinetic (PK) and pharmacodynamic (PD) properties following a single subcutaneous injection of epoetin alfa (Eporon) with those of the comparator (Eprex) in healthy male subjects.

SUBJECTS AND METHODS

A randomized, double-blind, two-sequence, crossover study was conducted. Subjects were randomly assigned to receive a single dose, that is, 4,000 IU, of the test or comparator epoetin alfa. After 4 weeks, all subjects received the alternative formulation. The primary PK parameters, maximum observed concentration (C) and area under the curve extrapolated to infinity (AUC), were calculated with the serum erythropoietin (EPO) concentrations from blood samples collected for 144 h after dosing. The reticulocyte, hematocrit, hemoglobin and red blood cell counts were measured up to 312 h as PD markers. The primary PD parameters, maximum observed effect (E) and area under the effect curve (AUEC), were obtained from the baseline-corrected reticulocyte count. The serum EPO concentration and the reticulocyte count were used to assess the concentration-response relationship. The tolerability and immunogenicity profiles were assessed together.

RESULTS

Forty-two subjects completed the study. The mean EPO concentration-time profiles were comparable between the two formulations. The geometric mean ratios (90% CI) of the C and AUC were 0.908 (0.843-0.978) and 1.049 (0.999-1.101), respectively, both of which were within the regulatory range of 0.80-1.25. Additionally, the PD and tolerability profiles were similar between the two formulations. The time-matched serum EPO concentration and PD markers presented a counterclockwise hysteresis, suggesting a time delay between the measured concentration and the response. Both formulations were well tolerated, and production of anti-drug antibodies was not observed.

CONCLUSION

The two epoetin alfa formulations had similar PK, PD and tolerability profiles. Furthermore, both formulations had a similar time-matched serum EPO concentration and erythropoietic response profile. Thus, the two formulations are expected to be used interchangeably in clinical settings.

摘要

目的

本研究旨在评估并比较健康男性受试者单次皮下注射阿法依泊汀(Eporon)与对照品(益比奥)后的药代动力学(PK)和药效学(PD)特性。

受试者与方法

进行了一项随机、双盲、双序列、交叉研究。受试者被随机分配接受单剂量,即4000国际单位的受试或对照阿法依泊汀。4周后,所有受试者接受另一种制剂。主要PK参数,即最大观察浓度(C)和外推至无穷大的曲线下面积(AUC),根据给药后144小时采集的血样中的血清促红细胞生成素(EPO)浓度进行计算。作为PD标志物,在长达312小时内测量网织红细胞、血细胞比容、血红蛋白和红细胞计数。主要PD参数,即最大观察效应(E)和效应曲线下面积(AUEC),从经基线校正的网织红细胞计数中获得。血清EPO浓度和网织红细胞计数用于评估浓度-反应关系。同时评估耐受性和免疫原性概况。

结果

42名受试者完成了研究。两种制剂的平均EPO浓度-时间曲线具有可比性。C和AUC的几何平均比值(90%CI)分别为0.908(0.843-0.978)和1.049(0.999-1.101),均在0.80-1.25的监管范围内。此外,两种制剂的PD和耐受性概况相似。时间匹配的血清EPO浓度和PD标志物呈现逆时针滞后现象,表明测量浓度与反应之间存在时间延迟。两种制剂耐受性良好,未观察到抗药抗体的产生。

结论

两种阿法依泊汀制剂具有相似的PK、PD和耐受性概况。此外,两种制剂具有相似的时间匹配血清EPO浓度和促红细胞生成反应概况。因此,预计这两种制剂在临床环境中可互换使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb6/5667778/1effa4e2e270/dddt-11-3127Fig1.jpg

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