Reginster J Y, Albert A, Deroisy R, Colette J, Vrijens B, Blacker C, Brion N, Caulin F, Mayolle C, Regnard A, Sholler R, Franchimont P
CHU Centre Ville, Liège, Belgium.
Scand J Rheumatol Suppl. 1996;103:94-8; discussion 99-100. doi: 10.3109/03009749609103761.
Circulating levels of 17 beta estradiol (E2) following the administration of fixed doses of E2, show a great variability in kinetics depending upon the product administrated, the routes of administration, and the interindividual variations in absorption and metabolism. This might have important implications both in terms of tolerance and effectiveness. Two new forms of transdermal E2 (SYSTEN Cilag and MENOREST Rhone-Poulenc Rorer) have been recently accepted in Europe for the treatment of climacteric symptoms. The present study was undertaken to compare the pharmacokinetic characteristics of plasma E2 profile under these two drugs. It was carried out in 30 healthy postmenopausal volunteers according to good clinical practice after informed consent, as a single blind, randomised, cross-over study during the classical wearing period of 4 days. Plasma E2 concentration was determined 24 hours before, 1/2 hour before and then 2, 4, 8, 12, 24, 48, 72, 84, 96 hours after the first patch administration. E2 measurement was performed using a specific direct radioimmunoassay developed in the FRH laboratories. The main criteria for this method were an intraassay coefficient of variation (CV) less than 6%, an interassay CV less than 8% in a concentration range of 15-140 pg/ml and a quantitative detection limit (LOQ) of 2.7 pg/ml with a 20% CV. The following kinetic parameters were analysed: C(max), C(mean), C96 and MRT. The bioequivalence was assessed by analysis of variance of C(max), C(mean), C96 and AuC after logarithmic transformation, complemented by Westlake test (95%). Data show that these two products are identical in terms of C(max) but C(mean), C96 and AuC are statistically greater when MENOREST 50(R) is administered; furthermore, E2 levels decrease more rapidly and more deeply with SYSTEN 50 than MENOREST 50. The differences of pharmacokinetic profiles after administration of two different forms of the same dose of 50 micrograms transdermal 17 beta estradiol might have important medical consequences.
给予固定剂量的17β-雌二醇(E2)后,其循环水平在动力学上表现出很大的变异性,这取决于所给药的产品、给药途径以及个体在吸收和代谢方面的差异。这在耐受性和有效性方面可能具有重要意义。两种新型经皮E2制剂(施维雅公司的SYSTEN和罗纳普朗克-乐仁堂公司的MENOREST)最近在欧洲已被批准用于治疗更年期症状。本研究旨在比较这两种药物作用下血浆E2水平的药代动力学特征。在30名健康绝经后志愿者中,按照良好临床实践,在获得知情同意后,进行了一项单盲、随机、交叉研究,研究周期为经典的4天贴片佩戴期。在首次贴片给药前24小时、前半小时,以及给药后2、4、8、12、24、48、72、84、96小时测定血浆E2浓度。使用法国卫生与医学研究院(FRH)实验室开发的特异性直接放射免疫分析法进行E2测定。该方法的主要标准为:批内变异系数(CV)小于6%,在15 - 140 pg/ml浓度范围内批间CV小于8%,定量检测限(LOQ)为2.7 pg/ml,CV为20%。分析了以下动力学参数:C(max)、C(mean)、C96和平均滞留时间(MRT)。通过对对数转换后的C(max)、C(mean)、C96和药时曲线下面积(AuC)进行方差分析,并辅以韦斯特莱克检验(95%)来评估生物等效性。数据表明,这两种产品在C(max)方面相同,但给予MENOREST 50(R)时,C(mean)、C96和AuC在统计学上更高;此外,与MENOREST 50相比,SYSTEN 50使E2水平下降得更快、更明显。给予相同剂量50微克经皮17β-雌二醇的两种不同制剂后药代动力学特征的差异可能具有重要的医学影响。