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HMG-CoA还原酶抑制剂西立伐他汀药代动力学的种族间比较。

Inter-ethnic comparisons of the pharmacokinetics of the HMG-CoA reductase inhibitor cerivastatin.

作者信息

Mück W, Unger S, Kawano K, Ahr G

机构信息

Institute of Clinical Pharmacology, Pharma Research Center, Bayer AG, Wuppertal, Germany.

出版信息

Br J Clin Pharmacol. 1998 Jun;45(6):583-90. doi: 10.1046/j.1365-2125.1998.00717.x.

Abstract

AIMS

During the world-wide clinical development of the HMG-CoA reductase inhibitor cerivastatin, pharmacokinetic data have been collected from studies performed in Europe, North America and Japan, covering different ethnic groups, mainly Caucasians and Japanese subjects, but also Black and Hispanics. The aim of the present investigation was to search for any inter-ethnic differences in cerivastatin pharmacokinetics.

METHODS

All concentration data were assessed by fully validated specific h.p.l.c. assays employing post-column photochemical derivatization with ultra-violet light and subsequent fluorescence detection. The comparability of analytical results was guaranteed by cross-validations between all analytical laboratories. The inter-ethnic comparison was based on retrospective analysis of the overall pharmacokinetic data pool (n = 340 complete profiles) in the key parameters AUC, Cmax, tmax and t1/2, assessed via non-compartmental methods.

RESULTS

Based on the comparison of selected individual single- and multiple-dose escalation studies in healthy young males, performed when starting the clinical development, exposure and disposition of the parent compound and its cytochrome P450-mediated biotransformation products M-1 and M-23, and amounts of metabolites M-1, M-23 and M-24 excreted in urine were comparable for US Americans, mainly Caucasians, and Japanese. Retrospective analysis of the complete pharmacokinetic data pool revealed that there are no statistically significant differences in dose-normalized AUC- and Cmax-values. The respective ratios of weight-adjusted geometric least-squares (LS) means (95% confidence intervals) between Japanese and Caucasians were: for AUCdose-norm 0.96 (0.86-1.08) for single dose, and 1.04 (0.86-1.24) for multiple dose; for Cmax,dose-norm 0.93 (0.83-1.05) for single dose, and 1.01 (0.82-1.25) for multiple dose. Half-life was slightly, but statistically significantly shorter in Japanese than in Caucasian subjects following single dose: ratios (95% CI) were 0.68 (0.61-0.77) for single dose, and 1.00 (0.79-1.26) for multiple dose. Times to peak tended to be slightly greater in Japanese: differences of weight-adjusted LS means (95% CI) were 0.60 h (0.28 h-0.92 h) for single dose, and 1.15 h (0.48 h-1.81 h) for multiple dose. Black and Hispanics did not differ in their pharmacokinetic characteristics from Caucasians.

CONCLUSIONS

Based on inter-study comparisons and a retrospective analysis of the complete PK data pool there is no evidence for any clinically relevant inter-ethnic differences in cerivastatin pharmacokinetics in Caucasians, Black and Japanese subjects after oral therapeutic doses.

摘要

目的

在HMG-CoA还原酶抑制剂西立伐他汀全球临床开发过程中,已从欧洲、北美和日本开展的研究中收集了药代动力学数据,这些研究涵盖了不同种族群体,主要是白种人和日本受试者,但也包括黑人和西班牙裔。本研究的目的是探寻西立伐他汀药代动力学方面的种族差异。

方法

所有浓度数据均通过采用柱后光化学衍生化及紫外光和随后的荧光检测的经过充分验证的特异性高效液相色谱分析方法进行评估。所有分析实验室之间的交叉验证确保了分析结果的可比性。种族间比较基于对总体药代动力学数据库(n = 340个完整数据)中关键参数AUC、Cmax、tmax和t1/2的回顾性分析,采用非房室方法进行评估。

结果

基于在临床开发开始时对健康年轻男性进行的选定单剂量和多剂量递增研究的比较,美国主要为白种人和日本受试者中,母体化合物及其细胞色素P450介导的生物转化产物M-1和M-23的暴露和处置情况,以及尿液中排泄的代谢物M-1、M-23和M-24的量具有可比性。对完整药代动力学数据库的回顾性分析显示,剂量标准化的AUC和Cmax值无统计学显著差异。日本人和白种人之间体重调整后的几何最小二乘(LS)均值(95%置信区间)的相应比值为:单剂量时AUCdose-norm为0.96(0.86 - 1.08),多剂量时为1.04(0.86 - 1.24);单剂量时Cmax,dose-norm为0.93(0.83 - 1.05),多剂量时为1.01(0.82 - 1.25)。单剂量后,日本人的半衰期略短,但在统计学上显著短于白种人受试者:比值(95%CI)单剂量时为0.68(0.61 - 0.77),多剂量时为1.00(0.79 - 1.26)。日本人达到峰值的时间往往略长:体重调整后的LS均值差异(95%CI)单剂量时为0.60小时(0.28小时 - 0.92小时),多剂量时为1.15小时(0.48小时 - 1.81小时)。黑人和西班牙裔在药代动力学特征上与白种人无差异。

结论

基于研究间比较和对完整PK数据库的回顾性分析,没有证据表明口服治疗剂量后,白种人、黑人和日本受试者在西立伐他汀药代动力学方面存在任何临床相关的种族差异。

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