Burggraaf J, van Haarst A D, Fockens P, Schoemaker H C, Krauwinkel W J, Cohen A F
Centre for Human Drug Research, Leiden, The Netherlands.
Br J Clin Pharmacol. 1998 Sep;46(3):207-14. doi: 10.1046/j.1365-2125.1998.00782.x.
To study the delivery of 15 mg beclomethasone 17,21-dipropionate (BDP) to the distal part of the small bowel for three oral sustained-release formulations (I-III) and a reference capsule in volunteer ileostomists, and to compare these findings with the in vitro dissolution profiles.
Two groups of nine ileostomy volunteers (aged 20-61 years), who were otherwise healthy, were enrolled in the study. The recovery of BDP and its metabolite beclomethasone 17-monopropionate (B17P) in ileostomy effluent was investigated in a cross-over study after administration of formulations I or II or a reference capsule containing micronised BDP, and in a second open study after administration of formulation III. Radio-opaque granules were coadministered for evaluation of gastrointestinal passage. Ileostomy effluents were collected hourly for 10-12 h following drug intake. After marker beads had been counted on X-rays, ileostomy collections were analysed for BDP and its metabolites. Cumulative recovery, lag-time and mean transit time were determined for drug and marker beads.
Gastrointestinal passage characteristics were similar for all treatments. Total drug recovery was approximately three times higher for the sustained-release formulations than for the reference capsule. Recovery of B17P from stoma fluid samples was significantly lower for formulation III than for formulations I and II.
The novel oral formulations delivered substantial amounts of steroid drug at the distal small bowel/proximal colon, which may warrant further studies to evaluate clinical applicability.
在志愿者回肠造口患者中,研究三种口服缓释制剂(I - III)和一种对照胶囊中15毫克倍氯米松17,21 - 二丙酸酯(BDP)在小肠远端的释放情况,并将这些结果与体外溶出曲线进行比较。
两组共18名回肠造口志愿者(年龄20 - 61岁,身体健康)参与本研究。在交叉研究中,给予制剂I或II或含微粉化BDP的对照胶囊后,以及在第二项开放性研究中给予制剂III后,研究回肠造口流出物中BDP及其代谢产物倍氯米松17 - 单丙酸酯(B17P)的回收率。同时给予不透射线颗粒以评估胃肠道通过情况。服药后每小时收集回肠造口流出物10 - 12小时。在X射线下对标记珠计数后,分析回肠造口收集物中的BDP及其代谢产物。确定药物和标记珠的累积回收率、滞后时间和平均通过时间。
所有治疗的胃肠道通过特征相似。缓释制剂的总药物回收率约为对照胶囊的三倍。制剂III从造口液样本中回收的B17P显著低于制剂I和II。
新型口服制剂在小肠远端/近端结肠释放了大量甾体药物,这可能值得进一步研究以评估其临床适用性。