le Cotonnec J Y, Porchet H C, Beltrami V, Khan A, Toon S, Rowland M
Medeval Ltd., Manchester, England.
Pharm Res. 1995 Jun;12(6):844-50. doi: 10.1023/a:1016204919251.
The study determined the pharmacokinetics of urinary human follicle stimulating hormone (u-hFSH) in 12 down-regulated healthy female volunteers.
Following pituitary desensitization, baseline FSH serum levels were measured over a 24-hour period. Then each subject received, in random order, single doses of u-hFSH (Metrodin), 75 IU, 150 IU and 300 IU iv, and 150 IU im on four occasions separated by washout periods of one week. Blood and urine samples were collected at preset times. FSH levels were measured by a immuno-radiometric assay and an in vitro rat granulosa cells aromatase bioassay.
All doses of u-hFSH were well tolerated. After an iv bolus, the pharmacokinetics of FSH were well described by a two-compartment open model. Immunoassay data showed that the total exposure to FSH was proportional to the administered dose. Mean total clearance of FSH was approximately 0.5 L.h-1 and renal clearance was 0.14 L.h-1. The volume of distribution at steady-state was around 8 liters. The distribution half-life was 2 h and the terminal half-life nearly one day. After im injection, almost two thirds of the administered dose was available systemically. The in vitro bioassay confirmed this pharmacokinetic analysis.
The estimation of the elimination half-life of around one day indicates that the maximal effect of a given dose of u-hFSH administered daily cannot be observed until 3 to 4 days of repeated administration. This indicates that, on a pure pharmacokinetic basis, physicians should wait at least 4 days to assess the efficacy of a given dose of u-hFSH and that they should not modify dosage too frequently.
本研究测定了12名经垂体降调节的健康女性志愿者中尿源性人卵泡刺激素(u-hFSH)的药代动力学。
垂体脱敏后,在24小时内测定基础血清促卵泡激素(FSH)水平。然后,每位受试者在四周内按随机顺序接受单剂量的u-hFSH(Metrodin),静脉注射75 IU、150 IU和300 IU,以及肌肉注射150 IU,每次给药间隔一周的洗脱期。在预设时间采集血液和尿液样本。采用免疫放射测定法和体外大鼠颗粒细胞芳香化酶生物测定法测定FSH水平。
所有剂量的u-hFSH耐受性良好。静脉推注后,FSH的药代动力学可用二室开放模型很好地描述。免疫测定数据表明,FSH的总暴露量与给药剂量成正比。FSH的平均总清除率约为0.5 L·h-1,肾清除率为0.14 L·h-1。稳态分布容积约为8升。分布半衰期为2小时,末端半衰期近一天。肌肉注射后,近三分之二的给药剂量可全身利用。体外生物测定证实了这一药代动力学分析。
消除半衰期约为一天的估计表明,每日给予一定剂量的u-hFSH,直到重复给药3至4天才能观察到最大效果。这表明,单纯基于药代动力学,医生应至少等待4天来评估给定剂量u-hFSH的疗效,且不应过于频繁地调整剂量。