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右酮洛芬的药代动力学不会因基因多态性而发生显著改变。

Dexketoprofen Pharmacokinetics is not Significantly Altered by Genetic Polymorphism.

作者信息

Mejía-Abril Gina, Zubiaur Pablo, Navares-Gómez Marcos, Villapalos-García Gonzalo, Román Manuel, Ochoa Dolores, Abad-Santos Francisco

机构信息

Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain.

UICEC Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Research Network), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain.

出版信息

Front Pharmacol. 2021 Apr 29;12:660639. doi: 10.3389/fphar.2021.660639. eCollection 2021.

Abstract

Dexketoprofen is the (S)-(+)-enantiomer of racemic ketoprofen, a nonsteroidal anti-inflammatory drug used for the management of different types of pain. To the best of our knowledge, no article was published to date on dexketoprofen pharmacogenetics. Thence, in this work, we aimed to explore the influence of sex, race and several single nucleotide polymorphisms (SNPs) in genes encoding metabolizing enzymes (e.g. or ) or transporters (e.g., ) in the pharmacokinetics and safety of dexketoprofen to explore whether dosing adjustments based on genetic polymorphism would be beneficial for its prescription. For this regard, 85 healthy volunteers enrolled in three bioequivalence clinical trials were genotyped for 46 SNPs in 14 genes. Women showed lower AUC adjusted by dose/weight (AUC/DW) and higher Vd/F and Cl/F than men ( < 0.05 in univariate and multivariate analysis). 1B allele, IM/PM and IM/PM phenotypes were related to drug accumulation (AUC/DW or Cmax/DW) compared to the *1 allele, NM/RM and NM/UM phenotypes ( < 0.05 in the univariate analysis). C1236TT, C3435TT and G2677A/TA/T alleles were related to lower Cmax/DW compared to C, C, and G alleles ( < 0.05 in univariate and multivariate analysis). C1236TT allele was also related to lower AUC/DW ( < 0.05 in multivariate analysis). The remaining studied transporter genes (, , and ) and metabolizing enzyme genes (, , , , , , and ) were unrelated to dexketoprofen pharmacokinetic variability. We conclude that dexketoprofen pharmacokinetics can be influenced by several polymorphisms, although there is not a clear pharmacogenetic predictor that would justify individualization of therapy based on its genotyping. Further studies should be conducted to confirm the role of SNPs in , , and on the pharmacokinetic variability of dexketoprofen. Current evidence on dexketoprofen pharmacogenetics does not justify its inclusion in pharmacogenetic guidelines.

摘要

右酮洛芬是消旋酮洛芬的(S)-(+)-对映体,消旋酮洛芬是一种用于治疗不同类型疼痛的非甾体抗炎药。据我们所知,迄今为止尚未发表关于右酮洛芬药物遗传学的文章。因此,在本研究中,我们旨在探讨性别、种族以及编码代谢酶(如 或 )或转运蛋白(如 、 )的基因中的几个单核苷酸多态性(SNP)对右酮洛芬药代动力学和安全性的影响,以探究基于基因多态性进行剂量调整是否有利于其处方用药。为此,对参与三项生物等效性临床试验的85名健康志愿者进行了14个基因中46个SNP的基因分型。女性的剂量/体重校正AUC(AUC/DW)较低,Vd/F和Cl/F较高,高于男性(单因素和多因素分析中P<0.05)。与*1等位基因、NM/RM和NM/UM表型相比,1B等位基因、IM/PM和IM/PM表型与药物蓄积(AUC/DW或Cmax/DW)相关(单因素分析中P<0.05)。与C、C和G等位基因相比,C1236TT、C3435TT和G2677A/TA/T等位基因与较低的Cmax/DW相关(单因素和多因素分析中P<0.05)。C1236TT等位基因也与较低的AUC/DW相关(多因素分析中P<0.05)。其余研究的转运蛋白基因( 、 、 和 )和代谢酶基因( 、 、 、 、 、 、 和 )与右酮洛芬药代动力学变异性无关。我们得出结论,右酮洛芬的药代动力学可能受多种多态性影响,尽管目前尚无明确的药物遗传学预测指标能够证明基于基因分型进行个体化治疗的合理性。应进一步开展研究以证实 、 、 和 基因中的SNP对右酮洛芬药代动力学变异性的作用。目前关于右酮洛芬药物遗传学的证据并不支持将其纳入药物遗传学指南。

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