Yang Eunsol, Lee Soyoung, Lee Heechan, Hwang Inyoung, Jang In-Jin, Yu Kyung-Sang, Lee SeungHwan
Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Republic of Korea.
Transl Clin Pharmacol. 2019 Dec;27(4):134-140. doi: 10.12793/tcp.2019.27.4.134. Epub 2019 Dec 31.
Combination therapies of antihypertensive drugs are recommended in cases where hypertension is not controlled by monotherapy. This study aimed to compare the pharmacokinetics (PKs) between fixed-dose combination (FDC) of fimasartan/amlodipine 60/10 mg and the corresponding loose combination. Because of the high intra-subject variability for maximum plasma concentration (C) of fimasartan, a randomized, open-label, 3×3 partial replicated crossover design was adopted. Subjects received a single dose of FDC of fimasartan/amlodipine 60/10 mg or the corresponding loose combination in each period. Blood samples for PK analysis were collected up to 48 hours for fimasartan and 144 hours for amlodipine, respectively. Geometric mean ratios (GMRs) and its 90% confidence intervals (CIs) of the FDC to the loose combination for C and area under the concentration-time curve from time 0 to the last quantifiable time point (AUC) were calculated. Sixty healthy subjects were randomized, and 57 subjects completed the study. The concentration-time profiles of fimasartan and amlodipine were similar between the FDC and loose combination. The GMRs (90% CIs) of the FDC to the loose combination for C and AUC were 1.0440 (0.9202-1.1844) and 1.0412 (0.9775-1.1090) for fimasartan, and 1.0430 (1.0156-1.0711) and 1.0339 (1.0055-1.0631) for amlodipine, respectively. The GMRs and its 90% CIs for C and AUC of fimasartan and amlodipine were included not only in the scaled bioequivalence criteria but also in the conventional bioequivalence criteria. In conclusion, FDC of fimasartan/amlodipine 60/10 mg showed comparable PK profiles with the corresponding loose combination, which suggests their bioequivalence.
对于单药治疗无法控制高血压的情况,推荐使用抗高血压药物联合疗法。本研究旨在比较非马沙坦/氨氯地平60/10毫克固定剂量复方制剂(FDC)与相应的松散联合用药之间的药代动力学(PKs)。由于非马沙坦的最大血药浓度(C)在受试者内变异性较高,因此采用了随机、开放标签、3×3部分重复交叉设计。受试者在每个周期接受单剂量的非马沙坦/氨氯地平60/10毫克FDC或相应的松散联合用药。分别在48小时内采集用于非马沙坦PK分析的血样,在144小时内采集用于氨氯地平PK分析的血样。计算FDC与松散联合用药在C以及从时间0至最后可定量时间点的浓度-时间曲线下面积(AUC)方面的几何平均比值(GMRs)及其90%置信区间(CIs)。60名健康受试者被随机分组,57名受试者完成了研究。非马沙坦和氨氯地平的浓度-时间曲线在FDC与松散联合用药之间相似。非马沙坦在C和AUC方面,FDC与松散联合用药的GMRs(90% CIs)分别为1.0440(0.9202 - 1.1844)和1.0412(0.9775 - 1.1090);氨氯地平在C和AUC方面,FDC与松散联合用药的GMRs(90% CIs)分别为1.0430(1.0156 - 1.0711)和1.0339(1.0055 - 1.0631)。非马沙坦和氨氯地平在C和AUC方面的GMRs及其90% CIs不仅包含在标度生物等效性标准内,也包含在传统生物等效性标准内。总之,非马沙坦/氨氯地平60/10毫克FDC与相应的松散联合用药显示出可比的PK特征,这表明它们具有生物等效性。