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健康受试者和痛风患者非布司他的群体药代动力学模型研究。

Population pharmacokinetic modelling of febuxostat in healthy subjects and people with gout.

机构信息

The George Institute for Global Health, Sydney, New South Wales, Australia.

St Vincent's Clinical School, University of New South Wales Sydney, New South Wales, Australia.

出版信息

Br J Clin Pharmacol. 2022 Dec;88(12):5359-5368. doi: 10.1111/bcp.15462. Epub 2022 Jul 28.

Abstract

AIMS

To investigate and characterise the pharmacokinetics of febuxostat and the effect of the covariates of renal function and body size descriptors on the pharmacokinetics of the drug.

METHODS

Blood samples (n = 239) were collected using sparse and rich sampling strategies from healthy (n = 9) and gouty (n = 29) subjects. Febuxostat plasma concentrations were measured by a validated high-performance liquid chromatography method. Population pharmacokinetic analysis was performed using NONMEM. A common variability on bioavailability (FVAR) approach was used to test the effect of fed status on absorption parameters. Covariates were modelled using a power model.

RESULTS

The time course of the plasma concentrations of febuxostat is best described by a two-compartment model. In the final model, the population mean for apparent clearance (CL/F), apparent central volume of distribution (Vc/F), apparent peripheral volume of distribution (Vp/F), absorption rate constant (ka) and apparent intercompartmental clearance (Q/F) were 6.91 l h , 32.8 l, 19.4 l, 3.6 h and 1.25 l h , respectively. The population parmater variability (coefficient of variation) for CL/F, Vc/F and Vp/F were 13.6, 22 and 19.5%, respectively. Food reduced the relative biovailability and ka by 67% and 87%, respectively. Renal function, as assessed by creatinine clearance, was a significant covariate for CL/F while body mass index was a significant covariate for Vc/F.

CONCLUSIONS

Renal function and body mass index were significant covariates. Further work is warranted to investigate the clinical relevance of these results, notably as renal impairment and obesity are common occurrences in people with gout.

摘要

目的

研究并描述非布司他的药代动力学特征,以及肾功能和身体尺寸描述符的协变量对药物药代动力学的影响。

方法

采用稀疏和丰富采样策略,从健康(n=9)和痛风(n=29)受试者中采集血样(n=239)。采用验证的高效液相色谱法测定非布司他的血浆浓度。采用 NONMEM 进行群体药代动力学分析。采用共同变异性生物利用度(FVAR)方法检验进食状态对吸收参数的影响。采用幂模型对协变量进行建模。

结果

非布司他的血浆浓度时间过程最好用双室模型来描述。在最终模型中,群体平均表观清除率(CL/F)、表观中央分布容积(Vc/F)、表观外周分布容积(Vp/F)、吸收速率常数(ka)和表观隔室间清除率(Q/F)分别为 6.91 l/h、32.8 l、19.4 l、3.6 h 和 1.25 l/h。CL/F、Vc/F 和 Vp/F 的群体参数变异性(变异系数)分别为 13.6%、22%和 19.5%。食物使相对生物利用度和 ka 分别降低了 67%和 87%。肌酐清除率评估的肾功能是 CL/F 的显著协变量,而体重指数是 Vc/F 的显著协变量。

结论

肾功能和体重指数是显著的协变量。需要进一步研究这些结果的临床意义,特别是在患有痛风的人群中,肾功能损害和肥胖症很常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2e6/9796681/8f24c0c26b4d/BCP-88-5359-g001.jpg

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