Journal of clinical pharmacology最新文献

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Haloperidol Versus 5-HT3 Receptor Antagonists for Postoperative Vomiting and QTc Prolongation: A Noninferiority Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials. 氟哌啶醇与5-HT3受体拮抗剂对术后呕吐和QTc延长的影响:随机对照试验的非劣效性荟萃分析和试验序贯分析
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2018-02-01 Epub Date: 2017-09-15 DOI: 10.1002/jcph.999
Preet Mohinder Singh, Anuradha Borle, Jeetinder Kaur Makkar, Anjan Trikha, David Fish, Ashish Sinha
{"title":"Haloperidol Versus 5-HT<sub>3</sub> Receptor Antagonists for Postoperative Vomiting and QTc Prolongation: A Noninferiority Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.","authors":"Preet Mohinder Singh,&nbsp;Anuradha Borle,&nbsp;Jeetinder Kaur Makkar,&nbsp;Anjan Trikha,&nbsp;David Fish,&nbsp;Ashish Sinha","doi":"10.1002/jcph.999","DOIUrl":"https://doi.org/10.1002/jcph.999","url":null,"abstract":"<p><p>Haloperidol is an antipsychotic with well-known antiemetic potential. It is underutilized for postoperative nausea vomiting due to reported corrected QT interval (QTc) prolongation. This meta-analysis evaluates its safety and efficacy as an antiemetic in the perioperative period. Trials comparing haloperidol to 5-HT<sub>3</sub> -receptor antagonists (5-HT<sub>3</sub> -RA) for 24 postoperative vomiting incidences published up to May 2017 were searched in the medical database. Comparisons were made for antiemetic efficiency variables (vomiting incidence, rescue antiemetic need, and patients with complete response) during early (until 6 hours) and late postoperative phases. Eight randomized controlled double-blinded trials were included in the final analysis. Twenty-four-hour vomiting incidence was similar in groups (fixed effects, P = 0.52, I<sup>2</sup> = 0%). Trial-sequential analysis confirmed noninferiority of haloperidol over 5-HT<sub>3</sub> -RAs (α = 5%, β = 20%, δ = 10%), with \"information size\" being 859 (required > 812). Pooled results did not demonstrate superiority/inferiority of 5-HT<sub>3</sub> -RAs over haloperidol in all other antiemetic efficacy variables (early and delayed). Negligible heterogeneity was found in all the comparisons made. Pooled Mantel Haenszel odds ratio for QTc prolongation was equivalent in both groups (fixed effects, P = 0.23, I<sup>2</sup> = 0%). The mean dose of haloperidol used was 1.34 mg, and no trial reported extrapyramidal side effects. Trial-sequential analysis showed statistical equivalence (α = 5%, β = 20%, δ = 10%), with information size being 745 (required > 591). Publication bias was unlikely (Egger test, X-intercept = 2.07, P = 0.10). We conclude that haloperidol is equivalent to the well-established 5-HT<sub>3</sub> -RAs in preventing vomiting during the first day after surgery. The incidence of QTc prolongation with haloperidol is statistically equivalent to 5-HT<sub>3</sub> -RAs and thus should not be the factor that discourages its use for treatment/prophylaxis of postoperative nausea vomiting.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"58 2","pages":"131-143"},"PeriodicalIF":2.9,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.999","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35516589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Effects of Rifampin on the Pharmacokinetics of a Single Dose of Istradefylline in Healthy Subjects. 利福平对健康受试者单剂量司他替林药代动力学的影响。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2018-02-01 Epub Date: 2017-09-07 DOI: 10.1002/jcph.1003
Mayumi Mukai, Tatsuo Uchimura, Xiaoping Zhang, Douglas Greene, Maria Vergeire, Marc Cantillon
{"title":"Effects of Rifampin on the Pharmacokinetics of a Single Dose of Istradefylline in Healthy Subjects.","authors":"Mayumi Mukai,&nbsp;Tatsuo Uchimura,&nbsp;Xiaoping Zhang,&nbsp;Douglas Greene,&nbsp;Maria Vergeire,&nbsp;Marc Cantillon","doi":"10.1002/jcph.1003","DOIUrl":"https://doi.org/10.1002/jcph.1003","url":null,"abstract":"<p><p>Istradefylline, a selective adenosine A<sub>2A</sub> inhibitor, is under development for the treatment of Parkinson's disease. The effect of oral steady-state rifampin 600 mg/day, a potent cytochrome P450 (CYP) 3A4 inducer, on the disposition of a single oral dose of istradefylline 40 mg was determined in a crossover study in 20 healthy subjects by measuring plasma concentrations of istradefylline and its M1 and M8 metabolites and their derived pharmacokinetic parameters. Based on the geometric mean ratio of log-transformed data, rifampin reduced istradefylline exposure: C<sub>max</sub> , 0.55 (90%CI, 0.49-0.62); AUC<sub>last</sub> , 0.21 (90%CI, 0.19-0.22); and AUC<sub>inf</sub> , 0.19 (90%CI, 0.18-0.20), indicating nonequivalence. These changes were primarily because of the effect of rifampin on the elimination parameters of istradefylline; mean CL/F was increased from 4.0 to 20.6 L/h, and mean t<sub>1/2</sub> was reduced from 94.8 to 31.5 hours. The effect of rifampin coadministration on the disposition of the istradefylline M1 and M8 metabolites was inconsistent and variable. Furthermore, as exposure of the istradefylline M1 and M8 metabolites in plasma was generally <9% of total drug exposure, it would be expected to have a negligible impact on the pharmacodynamic effect of istradefylline. Caution should be exercised when istradefylline is administered concurrently with strong CYP3A4 inducers and dose adjustment considered.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"58 2","pages":"193-201"},"PeriodicalIF":2.9,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.1003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35334089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Effect of Modafinil on Cognitive Function in Intensive Care Unit Patients: A Retrospective Cohort Study. 莫达非尼对重症监护病房患者认知功能的影响:一项回顾性队列研究。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2018-02-01 Epub Date: 2017-08-31 DOI: 10.1002/jcph.1002
Yoonsun Mo, Michael C Thomas, Todd A Miano, Leo I Stemp, Julia T Bonacum, Kathleen Hutchins, George E Karras
{"title":"Effect of Modafinil on Cognitive Function in Intensive Care Unit Patients: A Retrospective Cohort Study.","authors":"Yoonsun Mo,&nbsp;Michael C Thomas,&nbsp;Todd A Miano,&nbsp;Leo I Stemp,&nbsp;Julia T Bonacum,&nbsp;Kathleen Hutchins,&nbsp;George E Karras","doi":"10.1002/jcph.1002","DOIUrl":"https://doi.org/10.1002/jcph.1002","url":null,"abstract":"<p><p>Modafinil therapy, a nonamphetamine cognition-enhancing agent, holds the potential to improve recovery from cognitive impairment after intensive care unit (ICU) admission. To date, however, there is a paucity of data on modafinil use in the ICU setting. The purpose of this study was to explore the role of modafinil for improvement in cognition in ICU patients. This retrospective cohort study evaluated a total of 60 ICU patients with any ventilatory support who started on modafinil during their ICU stay from January 1, 2010, to March 19, 2016. The requirements of opioids and sedatives, as well as the lowest and average scores of the Glasgow Coma Scale (GCS) and Riker Sedation-Agitation Scale (SAS), were recorded during 48 hours before and after the start of modafinil therapy in 6-hour periods. The average daily modafinil dose of 170 mg was given for a median duration of 9 days. Modafinil administration was associated with a small, nonsignificant increase in GCS by 0.34 points after controlling for age, baseline severity of illness, and changes in sedation and analgesia over time (95%CI, -0.34 to 0.73 points; P = .0743). No major modafinil-associated adverse effects were observed. Modafinil administration did not significantly improve cognitive function in ICU patients within 48 hours of initiation. However, because of lack of robust evidence, the impact of modafinil on overall patient outcomes in the ICU remains unclear and needs further investigation.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"58 2","pages":"152-157"},"PeriodicalIF":2.9,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.1002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35362565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Repeated-Dose Oral N-Acetylcysteine in Parkinson's Disease: Pharmacokinetics and Effect on Brain Glutathione and Oxidative Stress. 重复剂量口服n -乙酰半胱氨酸在帕金森病中的药代动力学及对脑谷胱甘肽和氧化应激的影响
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2018-02-01 Epub Date: 2017-09-22 DOI: 10.1002/jcph.1008
Lisa D Coles, Paul J Tuite, Gülin Öz, Usha R Mishra, Reena V Kartha, Kathleen M Sullivan, James C Cloyd, Melissa Terpstra
{"title":"Repeated-Dose Oral N-Acetylcysteine in Parkinson's Disease: Pharmacokinetics and Effect on Brain Glutathione and Oxidative Stress.","authors":"Lisa D Coles,&nbsp;Paul J Tuite,&nbsp;Gülin Öz,&nbsp;Usha R Mishra,&nbsp;Reena V Kartha,&nbsp;Kathleen M Sullivan,&nbsp;James C Cloyd,&nbsp;Melissa Terpstra","doi":"10.1002/jcph.1008","DOIUrl":"https://doi.org/10.1002/jcph.1008","url":null,"abstract":"<p><p>Parkinson's disease (PD) is associated with oxidative stress and decreased nigral glutathione (GSH), suggesting that therapies that boost GSH may have a disease-modifying effect. Intravenous administration of a high dose of N-acetylcysteine (NAC), a well-known antioxidant and GSH precursor, increases blood and brain GSH in individuals with PD and with Gaucher disease and in healthy controls. To characterize the pharmacokinetics of repeated high oral doses of NAC and their effect on brain and blood oxidative stress measures, we conducted a 4-week open-label prospective study of oral NAC in individuals with PD (n = 5) and in healthy controls (n = 3). Brain GSH was measured in the occipital cortex using <sup>1</sup> H-MRS at 3 and 7 tesla before and after 28 days of 6000 mg NAC/day. Blood was collected prior to dosing and at predetermined collection times before and after the last dose to assess NAC, cysteine, GSH, catalase, malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE) concentrations and the reduced-to-oxidized GSH ratio (GSH/ glutathione disulfide [GSSG]). Symptomatic adverse events were reported by 3 of the 5 subjects with PD. NAC plasma concentration-time profiles were described by a first-order absorption, 1-compartment pharmacokinetic model. Although peripheral antioxidant measures (catalase and GSH/GSSG) increased significantly relative to baseline, indicators of oxidative damage, that is, measures of lipid peroxidation (4-HNE and MDA) were unchanged. There were no significant increases in brain GSH, which may be related to low oral NAC bioavailability and small fractional GSH/GSSG blood responses. Additional studies are needed to further characterize side effects and explore the differential effects of NAC on measures of antioxidant defense and oxidative damage.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"58 2","pages":"158-167"},"PeriodicalIF":2.9,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.1008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35538826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 100
Parent-Metabolite Pharmacokinetic Modeling and Pharmacodynamics of Veliparib (ABT-888), a PARP Inhibitor, in Patients With BRCA 1/2-Mutated Cancer or PARP-Sensitive Tumor Types. PARP 抑制剂 Veliparib(ABT-888)在 BRCA 1/2-突变癌症或 PARP 敏感型肿瘤患者中的母体代谢物药代动力学模型和药效学。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-07 DOI: 10.1002/jcph.892
Jing Niu, Christie Scheuerell, Shailly Mehrotra, Sharon Karan, Shannon Puhalla, Brian F Kiesel, Jiuping Ji, Edward Chu, Mathangi Gopalakrishnan, Vijay Ivaturi, Jogarao Gobburu, Jan H Beumer
{"title":"Parent-Metabolite Pharmacokinetic Modeling and Pharmacodynamics of Veliparib (ABT-888), a PARP Inhibitor, in Patients With BRCA 1/2-Mutated Cancer or PARP-Sensitive Tumor Types.","authors":"Jing Niu, Christie Scheuerell, Shailly Mehrotra, Sharon Karan, Shannon Puhalla, Brian F Kiesel, Jiuping Ji, Edward Chu, Mathangi Gopalakrishnan, Vijay Ivaturi, Jogarao Gobburu, Jan H Beumer","doi":"10.1002/jcph.892","DOIUrl":"10.1002/jcph.892","url":null,"abstract":"<p><p>Veliparib (ABT-888) is a novel oral poly-ADP-ribose polymerase (PARP) inhibitor that is being developed for the treatment of hematologic malignancies and solid tumors. Although the pharmacokinetics of veliparib have been studied in combination with cytotoxic agents, limited information exists regarding the pharmacokinetics (PK) of chronically dosed single-agent veliparib in patients with either BRCA 1/2-mutated cancer or PARP-sensitive tumors. The objectives of the current analysis were to characterize the population pharmacokinetics of veliparib and its primary, active metabolite, M8, and to evaluate the relationship between veliparib and M8 concentrations and poly-ADP-ribose (PAR) level observed in peripheral blood mononuclear cells (PBMCs). Seventy-one subjects contributed with veliparib plasma concentrations, M8 plasma concentrations, and PAR levels in PBMCs. Veliparib and M8 concentrations were modeled simultaneously using a population PK approach. A 2-compartment model with delayed first-order absorption and the elimination parameterized as renal (CL<sub>R</sub> /F) and nonrenal clearance (CL<sub>NR</sub> /F) adequately described veliparib pharmacokinetics. The pharmacokinetics of the M8 metabolite was described with a 2-compartment model. Creatinine clearance(CL<sub>CR</sub> ) and lean body mass (LBM) were identified as significant predictors of veliparib CL<sub>R</sub> /F and central volume of distribution, respectively. For a typical subject (LBM, 48 kg; CL<sub>CR</sub> , 95 mL/min), total clearance (CL<sub>R</sub> /F + CL<sub>NR</sub> /F), and central and peripheral volume of distribution for veliparib were estimated as 17.3 L/h, 98.7 L, and 48.3 L, respectively. At least 50% inhibition of PAR levels in PBMCs was observed at dose levels ranging from 50 to 500 mg.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"977-987"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503785/pdf/nihms854630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34894985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study. 他汀类药物与下消化道疾病:一项回顾性队列研究。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-11 DOI: 10.1002/jcph.895
Michelle Pearlman, Yvonne Covin, Robert Schmidt, Eric M Mortensen, Ishak A Mansi
{"title":"Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study.","authors":"Michelle Pearlman,&nbsp;Yvonne Covin,&nbsp;Robert Schmidt,&nbsp;Eric M Mortensen,&nbsp;Ishak A Mansi","doi":"10.1002/jcph.895","DOIUrl":"https://doi.org/10.1002/jcph.895","url":null,"abstract":"<p><p>Several studies have reported constipation, abdominal pain, or diarrhea as common adverse events for statins. Statins are among the most commonly prescribed medications, and the impact on the prevalence of these conditions was rarely studied as main outcomes. The aim of this study is to determine if statin therapy is associated with constipation, abdominal pain, diarrhea, or colitis. This was a retrospective cohort study using a regional military health care data from October 1, 2003, to March 1, 2012. A propensity score-matched cohort of statin users and nonusers was created based on 82 variables. The primary analysis evaluated the odds ratios of the following diagnoses: constipation, ≥3 encounters for constipation; abdominal pain, ≥3 encounters for abdominal pain; diarrhea, ≥3 encounters for diarrhea; colitis, ≥3 encounters for colitis; and endoscopy of the lower gastrointestinal tract, ≥3 endoscopies of the lower gastrointestinal tract. After propensity score matching of 6342 statin users and 6342 nonusers, there was no statistically significant difference in constipation (OR, 0.96; 95%CI, 0.87-1.05; P = .33), abdominal pain (OR, 0.95; 95%CI, 0.88-1.02; P = .15), or colitis (OR, 1.02; 95%CI, 0.91-1.14; P = .73). However, there was an association between statin therapy and endoscopy of the lower gastrointestinal tract (OR, 1.14; 95%CI, 1.04-1.26; P = .002) and decreased odds of diarrhea (OR, 0.88; 95%CI, 0.80-0.97; P = .01). In this retrospective cohort study, an association between statin therapy and increased likelihood of being diagnosed with lower gastrointestinal conditions could not be demonstrated, contrary to some statins package inserts.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"1053-1063"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34904221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Core Entrustable Professional Activities in Clinical Pharmacology for Entering Residency: Biologics. 进入住院医师的临床药理学核心可信赖的专业活动:生物制剂。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-06-14 DOI: 10.1002/jcph.938
Vera S Donnenberg, Maja Mandic, John C Rhee, Timothy F Burns, Bernd Meibohm, Joan M Korth-Bradley
{"title":"Core Entrustable Professional Activities in Clinical Pharmacology for Entering Residency: Biologics.","authors":"Vera S Donnenberg,&nbsp;Maja Mandic,&nbsp;John C Rhee,&nbsp;Timothy F Burns,&nbsp;Bernd Meibohm,&nbsp;Joan M Korth-Bradley","doi":"10.1002/jcph.938","DOIUrl":"https://doi.org/10.1002/jcph.938","url":null,"abstract":"<p><p>Biologicals are a rapidly expanding class of medications used in the treatment of many different conditions. This article reviews the common characteristics of this class and the requirements for safe and effective use in patients. Several vignettes are included to illustrate common challenges.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"947-955"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35088168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Pharmacokinetics of Macitentan in Patients With Pulmonary Arterial Hypertension and Comparison With Healthy Subjects. 马西坦在肺动脉高压患者体内的药动学及与健康人的比较。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-05 DOI: 10.1002/jcph.888
Milena Issac, Jasper Dingemanse, Patricia N Sidharta
{"title":"Pharmacokinetics of Macitentan in Patients With Pulmonary Arterial Hypertension and Comparison With Healthy Subjects.","authors":"Milena Issac,&nbsp;Jasper Dingemanse,&nbsp;Patricia N Sidharta","doi":"10.1002/jcph.888","DOIUrl":"https://doi.org/10.1002/jcph.888","url":null,"abstract":"<p><p>Macitentan is a worldwide approved dual endothelin receptor antagonist that has demonstrated efficacy in the treatment of pulmonary arterial hypertension (PAH) in a phase 3 clinical trial, SERAPHIN, at a dose of 10 mg once daily. During this trial, trough plasma concentrations (C<sub>trough</sub> ) of macitentan and its active metabolite,  ACT-132577,  were obtained at steady state in 242 patients, indicating that mean C<sub>trough</sub> of both analytes was about 2-fold higher in PAH patients than in healthy subjects. To further investigate the pharmacokinetics (PK) of macitentan and its active metabolite, ACT-132577,  a 24-hour PK profile was recorded at steady state in 20 PAH patients in the open-label extension of SERAPHIN.  A cross-study comparison showed that although C<sub>trough</sub> in PAH patients is higher when compared with a historical reference group of healthy subjects, with geometric mean ratios of 1.45 and 1.36 for macitentan and ACT-132577, respectively, this does not translate to a significant difference in exposure expressed as maximum plasma concentration (C<sub>max</sub> ) or area under the plasma concentration-time curve over a dosing interval (AUC<sub>τ</sub> ). Geometric mean ratios for C<sub>max</sub> and AUC<sub>τ</sub> were 1.08 and 1.22, respectively, for macitentan and 1.24 and 1.31, respectively, for ACT-132577. Therefore, overall exposure at steady state to macitentan and ACT-132577 in PAH patients is considered similar to that in healthy subjects.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"997-1004"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34887171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Influence of Meals and Glycemic Changes on QT Interval Dynamics. 膳食和血糖变化对 QT 间期动态的影响
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-05-22 DOI: 10.1002/jcph.933
Brenda Cirincione, Philip T Sager, Donald E Mager
{"title":"Influence of Meals and Glycemic Changes on QT Interval Dynamics.","authors":"Brenda Cirincione, Philip T Sager, Donald E Mager","doi":"10.1002/jcph.933","DOIUrl":"10.1002/jcph.933","url":null,"abstract":"<p><p>Thorough QT/QTc studies have become an integral part of early drug development programs, with major clinical and regulatory implications. This analysis expands on existing pharmacodynamic models of QT interval analysis by incorporating the influence of glycemic changes on the QT interval in a semimechanistic manner. A total of 21 healthy subjects enrolled in an open-label phase 1 pilot study and provided continuous electrocardiogram monitoring and plasma glucose and insulin concentrations associated with a 24-hour baseline assessment. The data revealed a transient decrease in QTc, with peak suppression occurring approximately 3 hours after the meal. A semimechanistic modeling approach was applied to evaluate temporal delays between meals and subsequent changes that might influence QT measurements. The food effect was incorporated into a model of heart rate dynamics, and additional delayed effects of the meal on QT were incorporated using a glucose-dependent hypothetical transit compartment. The final model helps to provide a foundation for the future design and analysis of QT studies that may be confounded by meals. This study has significant implications for QT study assessment following a meal or when a cohort is receiving a medication that influences postprandial glucose concentrations.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"966-976"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/60/JCPH-57-966.PMC5518218.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35027255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Population-Based Pharmacokinetic and Exposure-Efficacy Analyses of Peginterferon Beta-1a in Patients With Relapsing Multiple Sclerosis. 聚乙二醇干扰素β -1a在复发性多发性硬化症患者中基于人群的药代动力学和暴露-疗效分析
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-10 DOI: 10.1002/jcph.883
Xiao Hu, Yaming Hang, Yue Cui, Jie Zhang, Shifang Liu, Ali Seddighzadeh, Aaron Deykin, Ivan Nestorov
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引用次数: 7
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