Anderson Matt S, Gilmartin Jocelyn, Fan Li, Yee Ka Lai, Kraft Walter K, Triantafyllou Ilias, Reitmann Christina, Guo Ying, Liu Rachael, Iwamoto Marian
Merck & Co., Inc., Kenilworth, NJ, USA.
Present address: Certara USA, Inc., Princeton, NJ, USA.
Antivir Ther. 2019;24(6):443-450. doi: 10.3851/IMP3324.
Doravirine (DOR) is a novel non-nucleoside reverse transcriptase inhibitor available as a single tablet and a three-drug combination with lamivudine (3TC) and tenofovir disoproxil fumarate (TDF) to treat HIV-1 infection. These analyses assessed pharmacokinetic (PK) interactions with coadministration.
Two trials were conducted. Study 1: two-period, fixed-sequence; eight healthy participants; Period 1, DOR 100 mg followed by ≥7-day washout; Period 2, TDF 300 mg once daily for 18 days, coadministration of DOR 100 mg on day 14. Study 2: three-period, crossover, 15 healthy participants; Treatment A, DOR 100 mg; Treatment B, 3TC 300 mg + TDF 300 mg; Treatment C, DOR 100 mg + 3TC 300 mg + TDF 300 mg; ≥7-day washout between periods.
Study 1: geometric mean ratios (GMRs; 90% confidence interval [CI]) of DOR area under the concentration-time curve from time 0 extrapolated to infinity (AUC) and observed plasma concentrations at 24 h post-dose (C; DOR+TDF/DOR) were 0.95 (0.80, 1.12) and 0.94 (0.78, 1.12), respectively. Study 2: GMRs (90% CI) of DOR AUC and C (DOR+3TC+TDF/DOR) were 0.96 (0.87, 1.06) and 0.94 (0.83, 1.06), respectively. GMRs (90% CI) of 3TC and tenofovir AUC (DOR+3TC+TDF/3TC+TDF) were 0.94 (0.88, 1.00) and 1.11 (0.97, 1.28), respectively. Study drugs were generally well tolerated.
Multiple doses of TDF did not have a clinically meaningful effect on DOR PK. The PK of DOR were similar when administered alone or in combination with 3TC and TDF. DOR had no meaningful effect on the PK of 3TC and tenofovir.
多瑞韦(DOR)是一种新型非核苷类逆转录酶抑制剂,有单片制剂以及与拉米夫定(3TC)和替诺福韦酯富马酸盐(TDF)组成的三联药物组合,用于治疗HIV-1感染。这些分析评估了联合用药时的药代动力学(PK)相互作用。
进行了两项试验。研究1:两周期,固定顺序;8名健康参与者;第1周期,给予多瑞韦100mg,随后洗脱期≥7天;第2周期,每天给予替诺福韦酯300mg,共18天,在第14天联合给予多瑞韦100mg。研究2:三周期,交叉设计,15名健康参与者;治疗A,多瑞韦100mg;治疗B,3TC 300mg + 替诺福韦酯300mg;治疗C,多瑞韦100mg + 3TC 300mg + 替诺福韦酯300mg;周期之间洗脱期≥7天。
研究1:多瑞韦从0时到无穷大的浓度-时间曲线下面积(AUC)以及给药后24小时的实测血浆浓度(C;多瑞韦+替诺福韦酯/多瑞韦)的几何平均比值(GMRs;90%置信区间[CI])分别为0.95(0.80,1.12)和0.94(0.78,1.12)。研究2:多瑞韦AUC和C(多瑞韦+3TC+替诺福韦酯/多瑞韦)的GMRs(90%CI)分别为0.96(0.87,1.06)和0.94(0.83,1.06)。3TC和替诺福韦AUC(多瑞韦+3TC+替诺福韦酯/3TC+替诺福韦酯)的GMRs(90%CI)分别为0.94(0.88,1.00)和1.11(0.97,1.28)。研究药物总体耐受性良好。
多次给予替诺福韦酯对多瑞韦的药代动力学没有临床意义上的影响。单独给药或与3TC和替诺福韦酯联合给药时,多瑞韦的药代动力学相似。多瑞韦对3TC和替诺福韦的药代动力学没有显著影响。