West China Hospital, Sichuan University, Chengdu, China.
Beijing Anding Hospital, Capital Medical University, Beijing, China.
Adv Ther. 2019 Nov;36(11):3134-3146. doi: 10.1007/s12325-019-01092-4. Epub 2019 Sep 24.
Major depressive disorder (MDD) is associated with a significant burden of disease in China. Awareness and better access to treatments could help alleviate the burden associated with MDD. Because variations have been observed in the pharmacokinetics (PK) of antidepressants across different races and ethnicities, evaluation of the clinical pharmacology of vortioxetine in diverse populations remains important to assess the potential need for dose adjustments.
Data were pooled from two phase I open-label PK studies in healthy Chinese subjects, and one phase III double-blind noninferiority study in Chinese patients with MDD to describe the PK and safety data for vortioxetine. Doses in these studies ranged from 10 mg (single dose) to 10 and 20 mg (multiple daily doses). A population PK analysis of vortioxetine in the Chinese population was conducted using nonlinear mixed-effect modeling.
In total, 186 individuals were included in the PK analysis: 79 healthy Chinese subjects and 107 Chinese patients with MDD. No clinically significant differences in the PK of vortioxetine were observed between the Chinese population and the previous data in non-Chinese populations. Because of a generally lower weight in the Chinese population compared with the non-Chinese population, exposures were 19% and 18% higher in the Chinese population than in the non-Chinese population (for maximum observed plasma concentration and area under the plasma concentration-time curve, respectively), which is not considered clinically relevant. A high prevalence of pruritus was observed in one phase I PK study (56% overall); however, this was not reflected in the phase III study in Chinese patients with MDD (0.8%).
The PK parameters of vortioxetine in Chinese subjects were comparable to previous data in non-Chinese subjects. Overall, no new safety concerns were raised among the Chinese population. On the basis of this analysis, the tolerability profile of vortioxetine in Chinese healthy subjects and in patients with MDD is expected to be comparable to that in the non-Chinese population.
H. Lundbeck A/S, Valby, Denmark.
NCT01676571.
重度抑郁症(MDD)在中国造成了巨大的疾病负担。提高对这种疾病的认识并改善治疗方法的可及性,有助于减轻 MDD 相关负担。由于不同种族和民族之间抗抑郁药的药代动力学(PK)存在差异,因此评估文拉法辛在不同人群中的临床药理学仍然很重要,以评估是否需要调整剂量。
本文数据来自两项在中国健康受试者中进行的开放标签 PK 研究和一项在中国 MDD 患者中进行的 III 期双盲非劣效性研究,以描述文拉法辛在中国人群中的 PK 和安全性数据。这些研究中的剂量范围为 10mg(单次剂量)至 10mg 和 20mg(每日多次剂量)。使用非线性混合效应模型对文拉法辛在中国人群中的群体 PK 进行了分析。
共有 186 人纳入 PK 分析:79 名健康的中国受试者和 107 名中国 MDD 患者。在中国人群中,文拉法辛的 PK 与非中国人群的先前数据无临床显著差异。由于中国人群的体重普遍低于非中国人群,因此中国人群的暴露量分别比非中国人群高 19%和 18%(分别为最大观察到的血浆浓度和血浆浓度-时间曲线下面积),这并不被认为具有临床意义。在一项 I 期 PK 研究中观察到瘙痒的高发生率(总体为 56%);然而,在 III 期中国 MDD 患者研究中未观察到(0.8%)。
文拉法辛在中国受试者中的 PK 参数与非中国受试者中的先前数据相当。总体而言,在中国人群中未发现新的安全性问题。基于这项分析,预计文拉法辛在中国健康受试者和 MDD 患者中的耐受性特征与非中国人群相当。
丹麦 H. Lundbeck A/S。
NCT01676571。