Huang Lu, Yang Liu, Huang Jie, Tan Hong-Yi, Liu Shi-Kun, Guo Cheng-Xian, Zuo Xiao-Cong, Yang Guo-Ping, Pei Qi
Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People's Republic of China.
Reproductive and Genetic Hospital of Citic-Xiangya, Changsha, Hunan, 410013, People's Republic of China.
Eur J Drug Metab Pharmacokinet. 2019 Dec;44(6):797-806. doi: 10.1007/s13318-019-00567-7.
Telmisartan is an angiotensin receptor blocker used for the treatment of hypertension. The effects of gender and uridine diphosphate-glycosytransferase 1A1 (UGT1A1) genetic polymorphisms (rs4124874, rs4148323, and rs6742078) on telmisartan plasma concentration and blood pressure in Chinese patients with hypertension have been reported previously. In this study, we aimed to develop a population pharmacokinetic (PopPK) model to quantify the effects of gender and UGT1A1 polymorphisms on the pharmacokinetics of telmisartan.
Population pharmacokinetic analyses were performed using data collected prospectively from 58 Chinese patients with mild to moderate essential hypertension (aged 45-72 years; 36 men, 22 women) receiving 80 mg/day telmisartan orally for 4 weeks. Blood samples were collected in heparinized tubes at 0, 0.5, 1, and 6 h on day 28 after telmisartan administration. The plasma concentrations and UGT1A1 genetic variants were determined by high-performance liquid chromatography-mass spectrometry and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, respectively.
A two-compartment pharmacokinetic structural model with first-order elimination and absorption best described the pharmacokinetic characteristics of telmisartan. Gender and triglyceride influenced the apparent oral clearance (CL) of telmisartan. UGT1A1 (rs4124874) affected the bioavailability (F1) of telmisartan. Lower CL and bioavailability resulted in higher plasma concentrations being observed in female subjects with UGT1A1 CC or CA genotype and high triglyceride.
A PopPK model of telmisartan was established to confirm that UGT1A1 genotype, gender and triglyceride can affect the pharmacokinetics of telmisartan in Chinese patients with hypertension. Our findings can provide relevant pharmacokinetic parameters for further study of telmisartan.
替米沙坦是一种用于治疗高血压的血管紧张素受体阻滞剂。先前已有报道性别和尿苷二磷酸葡萄糖醛酸转移酶1A1(UGT1A1)基因多态性(rs4124874、rs4148323和rs6742078)对中国高血压患者替米沙坦血浆浓度和血压的影响。在本研究中,我们旨在建立一个群体药代动力学(PopPK)模型,以量化性别和UGT1A1基因多态性对替米沙坦药代动力学的影响。
使用前瞻性收集的58例中国轻至中度原发性高血压患者(年龄45 - 72岁;男性36例,女性22例)的数据进行群体药代动力学分析,这些患者口服80mg/天替米沙坦,持续4周。在替米沙坦给药后第28天的0、0.5、1和6小时,采集肝素抗凝管中的血样。分别通过高效液相色谱 - 质谱法和基质辅助激光解吸/电离飞行时间质谱法测定血浆浓度和UGT1A1基因变异。
具有一级消除和吸收的二室药代动力学结构模型最能描述替米沙坦的药代动力学特征。性别和甘油三酯影响替米沙坦的表观口服清除率(CL)。UGT1A1(rs4124874)影响替米沙坦的生物利用度(F1)。较低的CL和生物利用度导致UGT1A1 CC或CA基因型且甘油三酯水平高的女性受试者中观察到较高的血浆浓度。
建立了替米沙坦的PopPK模型,以证实UGT1A1基因型、性别和甘油三酯可影响中国高血压患者替米沙坦的药代动力学。我们的研究结果可为替米沙坦的进一步研究提供相关药代动力学参数。