Pharmacometrics, Pfizer Inc, La Jolla, California, USA.
Clinical Statistics, Pfizer Inc, Groton, Connecticut, USA.
Clin Pharmacol Drug Dev. 2021 Jul;10(7):707-717. doi: 10.1002/cpdd.897. Epub 2020 Dec 23.
This phase I open-label trial (NCT03627754) assessed glasdegib pharmacokinetics and safety in otherwise healthy participants with moderate (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment. Participants with hepatic impairment and age/weight-matched controls with normal hepatic function received a single oral 100-mg glasdegib dose under fasted conditions. The primary end points were area under the plasma concentration-time curve from time zero to infinity (AUC ) and maximum plasma concentration (C ). Twenty-four participants (8/cohort) were enrolled. Glasdegib plasma exposures in moderate hepatic impairment were similar to controls, with adjusted geometric mean ratios (GMRs) of 110.8% (90% confidence interval [CI], 78.0-157.3) for AUC and 94.8% (69.9-128.4) for C versus controls. In severe hepatic impairment, glasdegib plasma exposures were lower than controls (AUC GMR, 75.7%; 90%CI, 51.5-111.0; C GMR, 58.0%; 90%CI, 37.8-89.0). Unbound glasdegib exposures were similar to controls for moderate (AUC GMR, 118.1%; 90%CI, 88.7-157.2; C GMR, 101.1%; 90%CI, 78.4-130.3) and severe hepatic impairment (AUC GMR, 116.3%; 90%CI 81.8-165.5; C GMR, 89.2%, 90%CI, 60.2-132.3). No treatment-related adverse events or clinically significant changes in laboratory values, vital signs, or electrocardiograms were observed. Together with previous findings, this suggests glasdegib dose modifications are not required based on hepatic impairment.
这项 I 期开放标签试验(NCT03627754)评估了在肝功能中度(Child-Pugh B)或重度(Child-Pugh C)损害的健康参与者中,吉西他滨的药代动力学和安全性。有肝损伤的参与者和年龄/体重匹配的肝功能正常的对照组在空腹条件下接受单次口服 100mg 吉西他滨剂量。主要终点是从零时到无穷大的血浆浓度-时间曲线下面积(AUC )和最大血浆浓度(C )。共招募了 24 名参与者(每队列 8 名)。中度肝损伤患者的吉西他滨血浆暴露与对照组相似,调整后的几何均数比(GMR)分别为 AUC 的 110.8%(90%置信区间[CI],78.0-157.3)和 C 的 94.8%(69.9-128.4)与对照组相比。在严重肝损伤中,吉西他滨的血浆暴露低于对照组(AUC GMR,75.7%;90%CI,51.5-111.0;C GMR,58.0%;90%CI,37.8-89.0)。对于中度(AUC GMR,118.1%;90%CI,88.7-157.2;C GMR,101.1%;90%CI,78.4-130.3)和重度肝损伤(AUC GMR,116.3%;90%CI,81.8-165.5;C GMR,89.2%,90%CI,60.2-132.3),未观察到与治疗相关的不良事件或实验室值、生命体征或心电图的临床显著变化。与之前的发现相结合,这表明基于肝损伤不需要调整吉西他滨剂量。