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肾移植受者中两种霉酚酸酯制剂的药代动力学比较

Pharmacokinetic Comparison of Two Mycophenolate Mofetil Formulations in Kidney Transplant Recipients.

作者信息

Zhang Jun, Luo YongGang, Zhu ZhenFeng, Feng GuiWen, Sun Zhi, Zhang XiaoJian

机构信息

Departments of Pharmacy.

Integrated Intensive Care Unit, and.

出版信息

Ther Drug Monit. 2018 Oct;40(5):649-654. doi: 10.1097/FTD.0000000000000545.

DOI:10.1097/FTD.0000000000000545
PMID:29905619
Abstract

BACKGROUND

The aim of this study was to investigate and compare the pharmacokinetic (PK) characteristics of mycophenolate mofetil (MMF) capsule and MMF dispersible tablet by detecting the active metabolite of mycophenolic acid (MPA) in Chinese kidney transplant recipients.

METHODS

In the prospective, randomized, open-label study, the renal transplant patients were given a multiple dose of either the MMF capsule or MMF dispersible tablet combination with tacrolimus (Tac). For each patient, 11 serial blood samples were collected over 12 hours (h). Parameters including predose concentration (C0), postdose minimum and maximum concentration (Cmin and Cmax), time to Cmax (Tmax), total body clearance (CL), and area under the concentration-time curve for the 12-hour exposure (AUC0-12h) were determined. Patient interviews were conducted to assess the occurrence of adverse events.

RESULTS

Baseline characteristics were comparable between both groups. The C0, Cmin, Cmax, Tmax, CL, and AUC0-12h values were not significantly different after multiple doses of MMF capsule or MMF dispersible tablet (P > 0.05). The median values of AUC0-12h were 43.98 and 41.95 mcg·h/mL for MMF capsule and MMF dispersible tablet, respectively. Interindividual variability in Cmax, Cmin, and C0 were considerable in both groups. No serious adverse events were reported by patients or found on analysis of laboratory tests.

CONCLUSIONS

PK parameters of the 2 MPA drugs were comparable in early renal transplant patients in this study. The 2 formulations were well tolerated in Chinese kidney transplant patients.

摘要

背景

本研究旨在通过检测中国肾移植受者体内霉酚酸(MPA)的活性代谢物,研究并比较霉酚酸酯(MMF)胶囊和MMF分散片的药代动力学(PK)特征。

方法

在这项前瞻性、随机、开放标签研究中,肾移植患者接受多剂量的MMF胶囊或MMF分散片与他克莫司(Tac)联合用药。对每位患者在12小时内采集11份系列血样。测定包括给药前浓度(C0)、给药后最低和最高浓度(Cmin和Cmax)、达峰时间(Tmax)、总体清除率(CL)以及12小时暴露的浓度-时间曲线下面积(AUC0-12h)等参数。进行患者访谈以评估不良事件的发生情况。

结果

两组的基线特征具有可比性。多剂量服用MMF胶囊或MMF分散片后,C0、Cmin、Cmax、Tmax、CL和AUC0-12h值无显著差异(P>0.05)。MMF胶囊和MMF分散片的AUC0-12h中位数分别为43.98和41.95 mcg·h/mL。两组中Cmax、Cmin和C0的个体间变异性均较大。患者未报告严重不良事件,实验室检查分析也未发现严重不良事件。

结论

在本研究中,两种MPA药物的PK参数在早期肾移植患者中具有可比性。这两种制剂在中国肾移植患者中耐受性良好。

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