Stockis Armel, Nicolas Jean-Marie, Sargentini-Maier Maria Laura, Krauwinkel Walter
UCB Pharma, Braine-l'Alleud, Belgium.
Current affiliation: Sanofi, Diegem, Belgium.
Clin Pharmacol Drug Dev. 2023 Nov;12(11):1121-1127. doi: 10.1002/cpdd.1264. Epub 2023 May 22.
The pharmacokinetics, metabolism, safety, and tolerability of the antiseizure medication brivaracetam (BRV) were characterized in 16 healthy elderly participants (8 men/8 women) aged 65-78 years who received a single 200-mg oral dose of BRV on day 1, followed by 200 mg twice daily from day 3 until day 12. BRV and three metabolites were determined in plasma and urine. Adverse events, vital signs, electrocardiograms, laboratory tests, general and neurological examinations, and psychometric rating scales were recorded at regular intervals. No clinically relevant changes or abnormalities were detected. The adverse events were similar to those observed in pivotal trials. Rating scales indicated transiently increased sedation and decreased alertness. BRV pharmacokinetics and metabolism were unchanged relative to younger populations. Based on our observations in this healthy elderly population receiving oral BRV 200 mg twice daily (twice the maximum recommended dose), dose reductions are not warranted relative to other, younger populations. Further investigations may be necessary in frail elderly populations aged >80 years.
在16名年龄在65至78岁的健康老年参与者(8名男性/8名女性)中,对抗癫痫药物布立西坦(BRV)的药代动力学、代谢、安全性和耐受性进行了研究。这些参与者在第1天接受了单次200毫克的口服BRV剂量,随后从第3天至第12天每天两次服用200毫克。测定了血浆和尿液中的BRV及其三种代谢物。定期记录不良事件、生命体征、心电图、实验室检查、全身和神经系统检查以及心理测量评定量表。未检测到临床相关的变化或异常。不良事件与关键试验中观察到的相似。评定量表显示镇静作用短暂增加,警觉性降低。与年轻人群相比,BRV的药代动力学和代谢没有变化。基于我们对这一每天两次口服200毫克BRV(最大推荐剂量的两倍)的健康老年人群的观察,相对于其他年轻人群,无需减少剂量。对于年龄大于80岁的体弱老年人群,可能需要进一步研究。