González-Iglesias Eva, Ochoa Dolores, Román Manuel, Soria-Chacartegui Paula, Martín-Vilchez Samuel, Navares-Gómez Marcos, De Miguel Alejandro, Zubiaur Pablo, Rodríguez-Lopez Andrea, Abad-Santos Francisco, Novalbos Jesús
Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Faculty of Medicine, Universidad Autónoma de Madrid (UAM), Madrid, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
Front Pharmacol. 2024 May 3;15:1389968. doi: 10.3389/fphar.2024.1389968. eCollection 2024.
Bioequivalence clinical trials are conducted in healthy volunteers whose blood tests should be within normal limits; individuals with Gilbert syndrome (GS) are excluded from these studies on suspicion of any liver disease, even if the change is clinically insignificant. GS is a benign genetic disorder characterized by elevated bilirubin levels, the primary cause of which is the presence of polymorphisms in gene. In this work, subjects with UGT1A1 intermediate (IM) or poor (PM) metabolizer genotype-informed phenotypes were investigated to determine whether they have a higher incidence of liver disease or other biochemical parameters. The study population comprised 773 healthy volunteers who underwent biochemical analysis at baseline and at the end of the study which were genotyped for (rs887829), as an indicator of (rs887829 and rs3064744), and (rs4148323). Bilirubin levels were higher in subjects IMs and PMs compared to normal metabolizers (NMs). Decreased uric acid levels was observed in PMs compared to NMs. No associations were observed in liver enzyme levels according to UGT1A1 phenotype. Considering that there is no hepatic toxicity in subjects with UGT1A1 IM or PM phenotype, who are more likely to develop GS, this study suggests that they could be included in bioequivalence clinical trials as their biochemical parameters are not affected outside normal ranges.
生物等效性临床试验在血液检测结果应处于正常范围内的健康志愿者中进行;患有吉尔伯特综合征(GS)的个体因疑似患有任何肝脏疾病而被排除在这些研究之外,即使这种变化在临床上并不显著。GS是一种良性遗传疾病,其特征是胆红素水平升高,主要原因是基因中存在多态性。在这项研究中,对具有UGT1A1中间代谢型(IM)或慢代谢型(PM)基因型告知表型的受试者进行了调查,以确定他们是否有更高的肝脏疾病发病率或其他生化参数。研究人群包括773名健康志愿者,他们在基线和研究结束时接受了生化分析,并对(rs887829)进行基因分型,作为(rs887829和rs3064744)以及(rs4148323)的指标。与正常代谢者(NM)相比,IM和PM受试者的胆红素水平更高。与NM相比,PM受试者的尿酸水平降低。根据UGT1A1表型,未观察到肝酶水平存在关联。考虑到更有可能患GS的UGT1A1 IM或PM表型受试者不存在肝毒性,本研究表明他们可以纳入生物等效性临床试验,因为他们的生化参数在正常范围之外未受影响。