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福司列弗多巴/福卡比多巴经皮下输注后具有良好的耐受性,并能维持稳定的左旋多巴和卡比多巴暴露量。

Foslevodopa/Foscarbidopa Is Well Tolerated and Maintains Stable Levodopa and Carbidopa Exposure Following Subcutaneous Infusion.

机构信息

Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, IL, USA.

Drug Metabolism and Pharmacokinetics - Bioanalysis, AbbVie Inc., North Chicago, IL, USA.

出版信息

J Parkinsons Dis. 2021;11(4):1695-1702. doi: 10.3233/JPD-212813.

Abstract

BACKGROUND

Foslevodopa/foscarbidopa, formerly known as ABBV-951, is a formulation of levodopa/carbidopa prodrugs with solubility that allows for subcutaneous (SC) infusion and is in development for the treatment of motor complications for patients with advanced Parkinson's disease (aPD).

OBJECTIVE

The current work characterizes the levodopa (LD) and carbidopa (CD) pharmacokinetics (PK) following SC infusions of foslevodopa/foscarbidopa delivered at four different infusion rates in PD patients.

METHODS

This was a Phase 1, single ascending dose, single-blind study conducted in 28 adult male and female subjects at seven sites in the United States. Foslevodopa/foscarbidopa was administered via abdominal SC infusion in PD patients over 72 hours. Patients were stratified in 4 groups and received a fixed dose of foslevodopa/foscarbidopa based on their oral daily LD intake. Serial plasma PK samples were collected to assay for LD and CD concentrations. Safety and tolerability were assessed throughout the study.

RESULTS

LD exposure quickly reached steady state and remained stable with minimal fluctuations. Foslevodopa/foscarbidopa infusion provides stable LD and CD exposures compared to oral LD/CD dosing with the average steady-state exposure ranging from 747-4660 ng/mL for the different groups.

CONCLUSION

Foslevodopa/foscarbidopa was able to provide stable LD and CD exposures in PD patients over 72 hours via SC route of delivery with very low fluctuation in LD concentration level across a wide range of clinically relevant exposures. Foslevodopa/foscarbidopa had a favorable safety profile. The low PK fluctuation following foslevodopa/foscarbidopa infusion is expected to maintain LD exposure to treat aPD patients within a narrow therapeutic window.

摘要

背景

福司列汀/卡比多巴(foslevodopa/foscarbidopa),前称 ABBV-951,是一种左旋多巴/卡比多巴前药的制剂,具有提高溶解度的特点,可进行皮下输注,目前正在开发用于治疗晚期帕金森病(PD)患者的运动并发症。

目的

本研究旨在描述 PD 患者接受福司列汀/卡比多巴皮下输注后,左旋多巴(LD)和卡比多巴(CD)的药代动力学(PK)特征,输注速率设定为 4 个不同水平。

方法

这是一项在美国 7 个地点进行的 28 例成年男性和女性参与者参与的 1 期、单次递增剂量、单盲研究。PD 患者接受为期 72 小时的福司列汀/卡比多巴腹部皮下输注。患者根据其每日口服 LD 摄入量,分为 4 组,接受固定剂量的福司列汀/卡比多巴。采集系列血浆 PK 样本,以检测 LD 和 CD 浓度。整个研究过程中评估安全性和耐受性。

结果

LD 暴露迅速达到稳态,并保持稳定,波动极小。与口服 LD/CD 给药相比,福司列汀/卡比多巴输注可提供稳定的 LD 和 CD 暴露,不同组别的平均稳态暴露范围为 747-4660ng/mL。

结论

福司列汀/卡比多巴通过 SC 途径在 PD 患者中可提供 72 小时稳定的 LD 和 CD 暴露,LD 浓度水平波动极小,暴露范围广泛,具有临床相关性。福司列汀/卡比多巴具有良好的安全性特征。福司列汀/卡比多巴输注后 PK 波动低,有望将 LD 暴露维持在治疗 PD 患者的狭窄治疗窗内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d560/8609688/cdd939e7d126/jpd-11-jpd212813-g001.jpg

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