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达沙替尼的临床药代动力学和药效学。

Clinical Pharmacokinetics and Pharmacodynamics of Dasatinib.

机构信息

Pharmacy, Hôpital Hautepierre, Avenue Molière, 67000, Strasbourg, France.

Hematology, Hôpital Hautepierre, Avenue Molière, 67000, Strasbourg, France.

出版信息

Clin Pharmacokinet. 2020 Jul;59(7):849-856. doi: 10.1007/s40262-020-00872-4.

Abstract

Dasatinib is an oral, once-daily tyrosine kinase inhibitor used in the treatment of chronic myeloid leukaemia and Philadelphia chromosome-positive acute lymphoblastic leukaemia. Dasatinib is rapidly absorbed, with the time for maximal serum concentration varying between 0.25 and 1.5 h. Oral absorption is not affected by food. The absolute bioavailability of dasatinib in humans is unknown due to the lack of an intravenous formulation preventing calculation of the reference exposure. Dasatinib is eliminated through cytochrome P450 (CYP) 3A4-mediated metabolism, with a terminal half-life of 3-4 h. Based on total radioactivity, only 20% of the oral dose (100 mg) is recovered unchanged in faeces (19%, including potential non-absorption) and urine (1%) after 168 h. Dasatinib pharmacokinetics are not influenced by age (children, and adults up to 86 years of age), race and renal insufficiency. Dasatinib absorption is decreased by pH-modifying agents (antacids, H-receptor blockers, proton pump inhibitors), and dasatinib is also subject to drug interactions with CYP3A4 inducers or inhibitors.

摘要

达沙替尼是一种口服、每日一次的酪氨酸激酶抑制剂,用于治疗慢性髓性白血病和费城染色体阳性急性淋巴细胞白血病。达沙替尼吸收迅速,血清浓度达峰时间在 0.25 至 1.5 小时之间。食物不影响口服吸收。由于缺乏静脉制剂,无法计算参考暴露量,因此人体中达沙替尼的绝对生物利用度未知。达沙替尼通过细胞色素 P450(CYP)3A4 介导的代谢消除,终末半衰期为 3-4 小时。基于总放射性,在 168 小时后,粪便(19%,包括潜在的未吸收部分)和尿液(1%)中仅回收了 100mg 口服剂量(20%)的原形药物。达沙替尼药代动力学不受年龄(儿童和 86 岁以下成人)、种族和肾功能不全的影响。pH 调节剂(抗酸剂、H2 受体阻滞剂、质子泵抑制剂)会降低达沙替尼的吸收,并且达沙替尼还会受到 CYP3A4 诱导剂或抑制剂的药物相互作用的影响。

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