Leizorovicz A, Piolat C, Boissel J P, Sanchini B, Ferry S
Br J Clin Pharmacol. 1984 Jun;17(6):729-34. doi: 10.1111/j.1365-2125.1984.tb02410.x.
The bioequivalence of two forms of long acting quinidine compounds was assessed (Kinidin durules and Longacor) using drug plasma level and QT ECG changes. Six healthy volunteers received each preparation on two occasions in random order. The wash out period between successive experiments was at least 7 days. There was no difference in tmax, Cmax and AUC for plasma level and adjusted QT. However, between patient variability was large. A 20% difference in plasma levels could not be excluded but the difference in QT max and QT AUC between the two preparations did not exceed 20% (P less than 0.05, Westlake's method). This study illustrates the fact that pharmacodynamic equivalence, let alone therapeutic equivalence, does not necessarily imply plasma level equivalence, as assessed by the current method.
利用药物血浆水平和QT心电图变化评估了两种长效奎尼丁化合物(Kinidin缓释片和Longacor)的生物等效性。六名健康志愿者随机先后两次接受每种制剂。连续实验之间的洗脱期至少为7天。血浆水平和校正QT的达峰时间(tmax)、峰浓度(Cmax)和药时曲线下面积(AUC)没有差异。然而,患者之间的变异性很大。血浆水平20%的差异不能排除,但两种制剂之间的QT最大值和QT AUC差异不超过20%(P小于0.05,采用韦斯特莱克方法)。本研究说明了这样一个事实,即药效学等效性,更不用说治疗等效性,不一定意味着血浆水平等效,这是通过目前的方法评估得出的。