The George Institute for Global Health, Australia.
St Vincent's Clinical School, University of New South Wales, Australia.
Br J Clin Pharmacol. 2020 Dec;86(12):2486-2496. doi: 10.1111/bcp.14357. Epub 2020 Jun 18.
To examine the pharmacokinetic-phamacodynamic (PK-PD) relationships of plasma febuxostat and serum urate and the effect of a single dose of the drug on renal excretion and fractional clearance of urate (FCU).
Blood and urine samples were collected at baseline and up to 145 hours following administration of febuxostat (80 mg) to healthy subjects (n = 9). Plasma febuxostat and serum and urinary urate and creatinine concentrations were determined. Febuxostat pharmacokinetics were estimated using a two-compartment model with first-order absorption. An Emax PK-PD model was fitted to mean febuxostat and urate concentrations. Urinary urate excretion and FCU were calculated pre- and post-dose.
Maximum mean plasma concentration of febuxostat (2.7 mg L ) was observed 1.2 hours after dosage. Febuxostat initial and terminal half-lives were 2.0 ± 1.0 and 14.0 ± 4.7 hours (mean ± SD), respectively. The majority (81%) of the drug was eliminated in the 9 hours after dosing. Serum urate declined slowly achieving mean nadir (0.20 mmol L ) at 24 hours. The IC (plasma febuxostat concentration that inhibits urate production by 50%) was 0.11 ± 0.09 mg L (mean ± SD). Urinary urate excretion changed in parallel with serum urate. There was no systematic or significant change in FCU from baseline.
The PK-PD model could potentially be used to individualise febuxostat treatment and improve clinical outcomes. A single dose of febuxostat does not affect the efficiency of the kidney to excrete urate. Further investigations are required to confirm the present results following multiple dosing with febuxostat.
研究血浆非布司他和血清尿酸的药代动力学-药效学(PK-PD)关系,以及单次给药对尿酸肾排泄和分数清除率(FCU)的影响。
健康受试者(n=9)给予非布司他(80mg)后,在基线和 145 小时内采集血样和尿样。测定血浆非布司他和血清及尿尿酸和肌酐浓度。采用一阶吸收的两室模型估算非布司他药代动力学。采用 Emax PK-PD 模型拟合平均非布司他和尿酸浓度。计算给药前后尿尿酸排泄和 FCU。
给药后 1.2 小时观察到最大平均血浆非布司他浓度(2.7mg/L)。非布司他初始和终末半衰期分别为 2.0±1.0 和 14.0±4.7 小时(平均值±标准差)。给药后 9 小时内,大部分(81%)药物被消除。血清尿酸缓慢下降,24 小时达到平均最低点(0.20mmol/L)。抑制尿酸生成 50%的血浆非布司他浓度(IC)为 0.11±0.09mg/L(平均值±标准差)。尿尿酸排泄与血清尿酸变化平行。FCU 从基线开始没有系统或显著变化。
PK-PD 模型可能用于个体化非布司他治疗,改善临床结局。单次给药不会影响肾脏排泄尿酸的效率。需要进一步研究以确认非布司他多次给药后的现有结果。