Elexacaftor-tezacaftor-ivacaftor pharmacokinetics with concurrent tacrolimus administration after lung transplant.

IF 5.4 2区 医学 Q1 RESPIRATORY SYSTEM
J S Guimbellot, Ashritha Chalamalla, Elizabeth Baker, K J Ryan, A Dowell, Saly Abouelenein, L E Bartlett, J Bergeron, G Turner, E P Acosta, K J Ramos
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引用次数: 0

Abstract

Background: CFTR modulators in post-transplant people with cystic fibrosis (pwCF) are less frequently used due to uncertainty regarding effectiveness and interactions with immunosuppressive agents. Elexacaftor/tezacaftor/ivacaftor (ETI) is a triple combination cystic fibrosis (CF) therapeutic with benefits in multiple organ systems where complications can impact lung transplant (LTx) outcomes, including malnutrition, diabetes, and sinus disease. ETI use in LTx recipients is variable.

Methods: We conducted a pharmacokinetics (PK) study of concentrations of ETI parent compounds and the four major metabolites (M23-ELX, M1-TEZ, M1-IVA, M6-IVA) in a prospective non-randomized observational study, with all transplant participants concomitantly taking tacrolimus for LTx immunosuppression and excluded if taking any other medication with known interactions (e.g., azole antifungals) and compared to a non-transplant group of pwCF. We completed non-compartmental analysis (NCA) for both groups and compared the transplant to non-transplant PK parameters, as well as to published data from the manufacturer for non-transplant pwCF. Area under the curve (AUC), average concentrations (Cavg), minimum and maximum concentrations, clearance, and other parameters were determined.

Results: Twelve transplant and fourteen non-transplant participants with CF completed the study. There were no significant differences between the mean values for any PK parameters for the transplant and non-transplant groups and no substantial differences in frequency of concentrations outside the therapeutic ranges in the two groups.

Conclusions: Our data suggest there are not significant differences in concentrations of ELX, TEZ, IVA, or their major human metabolites in LTx recipients compared to non-transplant pwCF.

肺移植术后同时给予他克莫司的elexaftor - tezactor -ivacaftor药代动力学。
背景:CFTR调节剂在移植后囊性纤维化(pwCF)患者中较少使用,因为其有效性和与免疫抑制剂的相互作用存在不确定性。Elexacaftor/tezacaftor/ivacaftor (ETI)是一种三重联合治疗囊性纤维化(CF)的药物,对并发症可能影响肺移植(LTx)结果的多器官系统有益处,包括营养不良、糖尿病和窦性疾病。ETI在LTx接收者中的使用是可变的。方法:在一项前瞻性非随机观察性研究中,我们对ETI母体化合物和四种主要代谢物(M23-ELX, M1-TEZ, M1-IVA, M1-IVA)的浓度进行了药代动力学(PK)研究,所有移植参与者同时服用他克莫司用于LTx免疫抑制,如果服用任何其他已知相互作用的药物(例如,唑类抗真菌药物),则排除,并与未移植的pwCF组进行比较。我们完成了两组的非区室分析(NCA),并比较了移植与非移植的PK参数,以及非移植pwCF制造商公布的数据。测定曲线下面积(AUC)、平均浓度(Cavg)、最小和最大浓度、清除率等参数。结果:12名移植和14名非移植CF患者完成了研究。移植组和非移植组的任何PK参数的平均值之间没有显著差异,两组中浓度超出治疗范围的频率也没有实质性差异。结论:我们的数据表明,与非移植pwCF相比,LTx受体中ELX、TEZ、IVA或其主要人体代谢物的浓度没有显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cystic Fibrosis
Journal of Cystic Fibrosis 医学-呼吸系统
CiteScore
10.10
自引率
13.50%
发文量
1361
审稿时长
50 days
期刊介绍: The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.
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