Am J Vet Res. 2021 Jun;82(6):502-509. doi: 10.2460/ajvr.82.6.502.
To characterize the pharmacokinetics of mycophenolate mofetil (MMF) following single-dose IV or PO administration, characterize the pharmacokinetics of MMF following long-term PO administration, and describe the clinicopathologic effects of long-term MMF administration in horses.
12 healthy adult horses.
In phase 1, 6 horses received a single IV (2.5 mg/kg) or PO (5 mg/kg) dose of MMF in a randomized balanced crossover assessment (≥ 2-week interval between administrations). In phase 2, 6 other horses received MMF for 60 days (5 mg/kg, PO, q 24 h for 30 days and then 5 mg/kg, PO, q 48 h for an additional 30 days).
Following IV (single-dose) or PO (single- or multiple-dose) administration, MMF was rapidly converted to mycophenolic acid. For single-dose PO administration, mean ± SD maximum plasma mycophenolic acid concentration was 1,778.3 ± 441.5 ng/mL at 0.71 ± 0.29 hours. For single-dose IV administration, mean systemic clearance and volume of distribution at steady state were 0.689 ± 0.194 L/h/kg and 1.57 ± 0.626 L/kg, respectively. Following single doses, mean terminal half-life was 3.99 ± 0.865 hours for IV administration and 4.02 ± 1.01 hours for PO administration. The accumulation index following long-term PO administration was 1.0 ± 0.002, and the terminal half-life was 4.59 ± 1.25 hours following the final dose on day 60. None of the horses developed abnormal clinical signs or had any consistently abnormal clinicopathologic findings.
Further investigation of the clinical efficacy of long-term MMF treatment of horses with autoimmune diseases is warranted.
描述单次静脉注射或口服给药后霉酚酸酯(MMF)的药代动力学特征,描述长期口服给药后 MMF 的药代动力学特征,并描述马长期 MMF 给药的临床病理影响。
12 匹健康成年马。
在第 1 阶段,6 匹马以随机平衡交叉评估的方式接受单次静脉注射(2.5 mg/kg)或口服(5 mg/kg)MMF 剂量(给药之间间隔≥2 周)。在第 2 阶段,另外 6 匹马接受 MMF 治疗 60 天(5 mg/kg,口服,每天 2 次,持续 30 天,然后 5 mg/kg,口服,每 48 小时 1 次,再持续 30 天)。
静脉注射(单次剂量)或口服(单次或多次剂量)给药后,MMF 迅速转化为霉酚酸。对于单次口服给药,在 0.71 ± 0.29 小时时,最大血浆霉酚酸浓度的平均值±标准差为 1778.3 ± 441.5ng/mL。对于单次静脉注射给药,平均系统清除率和稳态分布容积分别为 0.689 ± 0.194 L/h/kg 和 1.57 ± 0.626 L/kg。单次给药后,静脉给药的平均终末半衰期为 3.99 ± 0.865 小时,口服给药的终末半衰期为 4.02 ± 1.01 小时。长期口服给药后的蓄积指数为 1.0 ± 0.002,第 60 天最后一次给药后终末半衰期为 4.59 ± 1.25 小时。没有马出现异常临床症状或任何持续异常的临床病理发现。
需要进一步研究马自身免疫性疾病长期 MMF 治疗的临床疗效。