Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland.
Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland.
Clin Ther. 2024 Sep;46(9):717-725. doi: 10.1016/j.clinthera.2024.07.007. Epub 2024 Aug 23.
We evaluated the pharmacokinetics, safety, and tolerability of a fixed-dose combination (FDC) of dapagliflozin/sitagliptin versus individual component (IC) tablets in healthy Western and Korean participants. The combination of these antihyperglycemic drugs provides efficient glucose control, and the use of FDC has generally been shown to improve medication adherence in individuals with type 2 diabetes mellitus (T2DM).
Two randomized, open-label, two-period, two-treatment, single-dose, single-center, crossover bioequivalence studies conducted on healthy fasted German participants (aged 18-55 years; Western study) and South Korean participants (aged 19-55 years; Korean study) were included. In both studies, pharmacokinetic parameters (maximum [peak] plasma concentration [C], area under the plasma concentration-time curve from zero to the last quantifiable concentration [AUC], and area under the plasma concentration-time curve from zero to infinity [AUC]) were used to assess the bioequivalence of 10 mg dapagliflozin/100 mg sitagliptin FDC (Treatment A) with their ICs (Treatment B) under fasted conditions. Safety and tolerability were assessed throughout the study.
Forty-six healthy participants (male, 60.9%; mean age, 39.5 years; mean body mass index [BMI], 23.9 kg/m) were randomized in the Western study, and 51 healthy participants (male, 100.0%; mean age, 24.6 years; mean BMI, 23.9 kg/m) were randomized in the Korean study. In both studies, the participants were randomized 1:1 into treatment sequence AB and treatment sequence BA. Dapagliflozin/sitagliptin FDC was bioequivalent to IC tablets in both Western and Korean studies, as the 90% confidence interval of the FDC to IC ratios of the geometric least-squares means of the pharmacokinetic parameters for both dapagliflozin and sitagliptin was within the 0.8000-1.2500 bioequivalence criterion limit. The observed differences in pharmacokinetic parameters, such as C, AUC, and AUC, between the Western and Korean studies were not clinically meaningful. Dapagliflozin/sitagliptin FDC and their ICs were well tolerated, with no serious adverse events reported in any of the study populations.
The 10 mg dapagliflozin/100 mg sitagliptin FDC and IC formulations were bioequivalent in fasted healthy Western and Korean participants, with no new safety concerns identified, thus offering a useful alternative for patients currently receiving individual medications as part of their treatment regimen.
Western study (clinicaltrials.gov: NCT05266404) and Korean study (clinicaltrials.gov: NCT05453786).
我们评估了达格列净/西他列汀固定剂量复方(FDC)与单药片剂在健康西方和韩国参与者中的药代动力学、安全性和耐受性。这些抗高血糖药物的联合使用可提供有效的血糖控制,并且使用 FDC 通常已被证明可提高 2 型糖尿病(T2DM)患者的用药依从性。
纳入了两项在健康禁食的德国参与者(年龄 18-55 岁;西方研究)和韩国参与者(年龄 19-55 岁;韩国研究)中进行的随机、开放标签、两周期、两治疗、单次、单中心、交叉生物等效性研究。在两项研究中,药代动力学参数(最大[峰]血浆浓度 [C]、从零到最后可量化浓度的血浆浓度-时间曲线下面积 [AUC]和从零到无穷大的血浆浓度-时间曲线下面积 [AUC])用于评估 10mg 达格列净/100mg 西他列汀 FDC(治疗 A)与单药片剂(治疗 B)在禁食条件下的生物等效性。在整个研究过程中评估了安全性和耐受性。
在西方研究中,46 名健康参与者(男性,60.9%;平均年龄,39.5 岁;平均体重指数 [BMI],23.9kg/m)被随机分组,51 名健康参与者(男性,100.0%;平均年龄,24.6 岁;平均 BMI,23.9kg/m)被随机分组在韩国研究中。在两项研究中,参与者按 1:1 随机分为 AB 治疗顺序和 BA 治疗顺序。达格列净/西他列汀 FDC 在西方和韩国研究中均与单药片剂生物等效,因为达格列净和西他列汀药代动力学参数的几何均数最小二乘比的 90%置信区间在 0.8000-1.2500 生物等效性标准范围内。在西方和韩国研究中观察到的药代动力学参数(如 C、AUC 和 AUC)差异无临床意义。达格列净/西他列汀 FDC 和其单药片剂耐受性良好,在任何研究人群中均未报告严重不良事件。
在健康的西方和韩国参与者中,10mg 达格列净/100mg 西他列汀 FDC 和单药制剂具有生物等效性,未发现新的安全性问题,因此为目前正在接受个体药物治疗的患者提供了一种有用的替代方案。
西方研究(clinicaltrials.gov:NCT05266404)和韩国研究(clinicaltrials.gov:NCT05453786)。