Boinpally Ramesh R, Trugman Joel M
Clinical Pharmacology, AbbVie, North Chicago, IL, USA.
Clin Pharmacol Drug Dev. 2024 Nov;13(11):1212-1218. doi: 10.1002/cpdd.1451. Epub 2024 Jul 12.
Atogepant, an oral calcitonin gene-related peptide receptor antagonist, is approved for the preventive treatment of migraine. A phase 1, open-label, single-dose, 2-period crossover study evaluated the effect of a high-fat meal on the pharmacokinetics and safety of atogepant in 20 healthy adults. Administration of atogepant 60 mg immediate-release (IR) tablets under fed conditions reduced the area under the plasma concentration-time curve (AUC) from 0 to time t and from 0 to time infinity by approximately 18% and reduced the maximum plasma concentration (C) by 22%. The 90% confidence intervals for the geometric mean ratios of C and AUC were not contained within the bioequivalence limits of 80%-125%. There was no change in the median time to maximum plasma concentration in the fed versus fasted state. The incidence of treatment-emergent adverse events (TEAEs) was similar between fed and fasted conditions. Four TEAEs were considered related to study intervention and were reported after participants received atogepant under fasted conditions (3 participants). A single-dose atogepant 60 mg IR tablet was safe and tolerated under both fed and fasted states. Due to the wide effective dose range of 10-60 mg/day for atogepant for the preventive treatment of migraine, the food effect on its pharmacokinetics is not considered clinically relevant.
阿托格潘是一种口服降钙素基因相关肽受体拮抗剂,已被批准用于偏头痛的预防性治疗。一项1期、开放标签、单剂量、两阶段交叉研究评估了高脂餐对20名健康成年人中阿托格潘药代动力学和安全性的影响。在进食条件下服用60毫克速释(IR)阿托格潘片,使血浆浓度-时间曲线(AUC)从0到时间t以及从0到无穷大的面积分别降低了约18%,并使最大血浆浓度(C)降低了22%。C和AUC几何平均比值的90%置信区间不在80%-125%的生物等效性限度内。进食状态与禁食状态下达到最大血浆浓度的中位时间没有变化。进食和禁食条件下治疗中出现的不良事件(TEAE)发生率相似。有4例TEAE被认为与研究干预有关,且是在参与者禁食状态下接受阿托格潘后报告的(3名参与者)。单剂量60毫克IR阿托格潘片在进食和禁食状态下均安全且耐受性良好。由于阿托格潘用于偏头痛预防性治疗的有效剂量范围为10 - 60毫克/天,其药代动力学的食物效应在临床上不被认为具有相关性。