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与完整的奥马维洛酮胶囊给药相比,将奥马维洛酮胶囊撒在苹果酱上并与之混合时的相对生物利用度:一项在健康成年人中进行的1期随机、开放标签、单剂量、交叉研究。

Relative Bioavailability of Omaveloxolone When Capsules Are Sprinkled Over and Mixed in Applesauce Compared With Administration as Intact Omaveloxolone Capsules: A Phase 1, Randomized, Open-Label, Single-Dose, Crossover Study in Healthy Adults.

作者信息

Hynes Scott M, Goldsberry Angie, Henneghan Patrick D, Murai Masako, Shinde Aparna, Wells Jason A, Wu Lucy, Wu Tony, Zahir Hamim, Khan Seemi

机构信息

Biogen Inc., Cambridge, Massachusetts, USA.

Thermo Fisher Scientific Inc., Bend, Oregon, USA.

出版信息

J Clin Pharmacol. 2024 Oct;64(10):1304-1311. doi: 10.1002/jcph.2482. Epub 2024 Jun 4.

Abstract

Omaveloxolone (SKYCLARYS) is approved for the treatment of Friedreich ataxia (FA) in patients aged ≥16 years in the United States and European Union (EU). The recommended dosage is 150 mg administered orally once daily as three 50-mg capsules. However, some patients with FA may have oropharyngeal dysphagia or difficulty swallowing whole capsules; therefore, alternate method(s) of administration are needed. A Phase 1 clinical study in 32 healthy volunteers evaluated the relative bioavailability, safety, and tolerability of a single dose of omaveloxolone when capsule contents were sprinkled on and mixed in applesauce compared to when taken as intact capsules. Palatability when sprinkled on and mixed in applesauce was assessed with a questionnaire. After a single 150-mg dose, the peak and overall exposures of omaveloxolone were similar irrespective of administration method, with the 90% CIs of the geometric least squares mean ratio (%) for maximum plasma concentration (C), AUC, and AUC within the 80% to 125% reference intervals. Omaveloxolone was absorbed more slowly as intact capsules (median t, 10 h) compared with sprinkled capsule contents over applesauce (median t, 6 h). With chronic daily administration of omaveloxolone to treat FA, the 4-h difference in t is not considered clinically relevant. Sprinkled omaveloxolone capsule contents on applesauce were well tolerated, with acceptable palatability and no serious adverse events. Given the similar systemic exposure when capsules were swallowed whole, sprinkling omaveloxolone capsule contents on and mixing in applesauce is a feasible alternative method of administering omaveloxolone and has been included in both the United States and EU prescribing information.

摘要

奥马维洛酮(SKYCLARYS)在美国和欧盟被批准用于治疗16岁及以上患者的弗里德赖希共济失调(FA)。推荐剂量为150毫克,口服,每日一次,服用三粒50毫克胶囊。然而,一些FA患者可能存在口咽吞咽困难或难以吞咽整粒胶囊的情况;因此,需要其他给药方法。一项针对32名健康志愿者的1期临床研究评估了单剂量奥马维洛酮的相对生物利用度、安全性和耐受性,将胶囊内容物洒在苹果酱上并与之混合服用与完整胶囊服用进行比较。通过问卷调查评估洒在苹果酱上并与之混合时的口感。单次服用150毫克剂量后,无论给药方法如何,奥马维洛酮的峰值和总体暴露量相似,最大血浆浓度(C)、AUC以及80%至125%参考区间内的AUC的几何最小二乘均值比(%)的90%置信区间均在此范围内。与将胶囊内容物洒在苹果酱上相比,完整胶囊形式的奥马维洛酮吸收更慢(中位t,10小时)(洒在苹果酱上时中位t,6小时)。在长期每日服用奥马维洛酮治疗FA时,t方面4小时的差异不被认为具有临床相关性。洒在苹果酱上的奥马维洛酮胶囊内容物耐受性良好,口感可接受,且无严重不良事件。鉴于整粒吞咽胶囊时全身暴露相似,将奥马维洛酮胶囊内容物洒在苹果酱上并与之混合是一种可行的奥马维洛酮替代给药方法,已被纳入美国和欧盟的处方信息中。

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