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用于肺动脉高压的吸入药物的临床药代动力学

Clinical Pharmacokinetics of Inhaled Drugs for Pulmonary Hypertension.

作者信息

Lin Yu, Su Yuanqi, Cheng Zhongjie, Zhu Bing, Pei Qi

机构信息

Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China.

Respirent Pharmaceuticals Co., Ltd, 5 Yuntu Road, Chongqing, 400714, China.

出版信息

Clin Pharmacokinet. 2025 May 28. doi: 10.1007/s40262-025-01525-0.

Abstract

Pulmonary hypertension (PH) is a serious condition characterized by elevated blood pressure in the pulmonary arteries. Current treatment approaches mainly focus on using vasodilator agents to reduce pulmonary blood pressure and improve blood flow. Inhalation treatments offer targeted delivery to the lungs, improving efficacy and reducing systemic side effects. Understanding the pharmacokinetics (PK) of the molecules used in the inhalation treatment is crucial for dose optimization and drug product development. This review examines the clinical PK characteristics of key inhaled PH drugs (approved and investigational agents), including epoprostenol, iloprost, treprostinil, vardenafil, imatinib, seralutinib, MK-5475, milrinone, and sodium nitrite. We provide detailed analyses of their PK parameters and explore how disease conditions, inter-subject variability, and inhaled formulations and devices impact clinical PK characteristics. Future research would focus on how disease-specific factors affect drug behavior and the prediction of pulmonary drug concentrations. This will support more precise drug delivery and personalized treatment strategies for PH.

摘要

肺动脉高压(PH)是一种严重的病症,其特征是肺动脉血压升高。目前的治疗方法主要集中在使用血管扩张剂来降低肺动脉血压并改善血流。吸入治疗可将药物靶向递送至肺部,提高疗效并减少全身副作用。了解吸入治疗中所用分子的药代动力学(PK)对于剂量优化和药品开发至关重要。本综述考察了关键吸入性PH药物(已批准和研究中的药物)的临床PK特性,包括依前列醇、伊洛前列素、曲前列尼尔、伐地那非、伊马替尼、塞来替尼、MK-5475、米力农和亚硝酸钠。我们对其PK参数进行了详细分析,并探讨了疾病状况、个体间变异性以及吸入制剂和装置如何影响临床PK特性。未来的研究将聚焦于疾病特异性因素如何影响药物行为以及肺部药物浓度的预测。这将支持更精确的药物递送以及针对PH的个性化治疗策略。

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