Journal of Clinical Pharmacology最新文献

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Pharmacogenetic Approaches to Optimize Bioequivalence Studies in Generic Drug Development. 优化仿制药开发中生物等效性研究的药物遗传学方法。
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-11 DOI: 10.1002/jcph.70058
Jihyun Bae, Jihong Shon, Myong-Jin Kim, Karen Li
{"title":"Pharmacogenetic Approaches to Optimize Bioequivalence Studies in Generic Drug Development.","authors":"Jihyun Bae, Jihong Shon, Myong-Jin Kim, Karen Li","doi":"10.1002/jcph.70058","DOIUrl":"https://doi.org/10.1002/jcph.70058","url":null,"abstract":"<p><p>Given the significant impacts of interindividual genetic variability on drug safety and pharmacokinetics, integrating pharmacogenetic (PGx) considerations into pharmacokinetic (PK) bioequivalence (BE) study design can improve subject safety and data robustness in generic drug development. While PGx information has been often utilized in new drug development, its use in generic drug development has not been fully considered. To understand the current landscape of its utility in generic drug development, product-specific guidances (PSGs) from the US Food and Drug Administration (FDA) containing PGx information were reviewed, along with study protocols submitted by generic drug applicants under abbreviated new drug applications (ANDAs) or controlled correspondences for the identified reference listed drugs (RLDs). Fifteen PSGs (15 RLDs) recommended PGx information as a consideration factor for subject population selection, particularly for drugs associated with inherited enzyme deficiencies or cytochrome P450 polymorphism. The PGx-based considerations in these PSGs aimed to prevent serious adverse events (60%), optimize PK BE study design (7%), or address both factors (33%). Among the 15 RLDs, 5 had submitted ANDAs or correspondences with PK BE study protocols after their respective PSGs were published. Most of these submissions aligned with the PSG recommendations, incorporating PGx-related exclusion criteria. These findings suggest that while the number of submissions is low, generic drug developers are increasingly integrating PGx considerations in PK BE studies, recognizing its potential to enhance safety and efficiency in generic drug development. Continuing efforts from both regulators and industry are critical to expand its application to other drug candidates.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276396","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: 0
Infliximab Pharmacokinetics, Dosing, and Response in Hospitalized Patients with COVID-19 Pneumonia: A Secondary Analysis of a Multinational Randomized Clinical Trial (ACTIV-1 IM). 英夫利昔单抗在COVID-19肺炎住院患者中的药代动力学、给药和反应:一项多国随机临床试验(ACTIV-1 IM)的二次分析
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-09 DOI: 10.1002/jcph.70057
Stephen J Balevic, Daniel Gonzalez, P Brian Smith, William G Powderly, Andreas Schmid, Ashley Kang, Matthew W McCarthy, Linda K Shaw, Christopher J Lindsell, Sam Bozzette, Richard M W Hoetelmans, Christoph P Hornik, Daniel K Benjamin
{"title":"Infliximab Pharmacokinetics, Dosing, and Response in Hospitalized Patients with COVID-19 Pneumonia: A Secondary Analysis of a Multinational Randomized Clinical Trial (ACTIV-1 IM).","authors":"Stephen J Balevic, Daniel Gonzalez, P Brian Smith, William G Powderly, Andreas Schmid, Ashley Kang, Matthew W McCarthy, Linda K Shaw, Christopher J Lindsell, Sam Bozzette, Richard M W Hoetelmans, Christoph P Hornik, Daniel K Benjamin","doi":"10.1002/jcph.70057","DOIUrl":"https://doi.org/10.1002/jcph.70057","url":null,"abstract":"<p><p>Infliximab may play an important role in reducing mortality in severe COVID-19, though optimal dosing is unknown. This secondary analysis of the ACTIV-1 IM trial characterized infliximab pharmacokinetics and outcomes in patients hospitalized with severe COVID-19. ACTIV-1 IM included patients admitted with COVID-19 pneumonia who received infliximab in addition to routine care. Infliximab was administered as a single 5-mg/kg intravenous dose. The primary exposure variable was predicted infliximab concentrations over 28 days (AUC<sub>0-28</sub>). Logistic regression modeling was used to relate AUC<sub>0-28</sub> to the primary outcome of 28-day mortality, adjusted for age. The relationship between AUC<sub>0-28</sub> and the secondary outcome of time to recovery was evaluated using a Fine-Gray model, adjusted for age, with death as a competing risk. AUC<sub>0-28</sub> was higher in patients who did not die versus those who died, with a median (range) of 20,681 mg h/L (8379-60,322) versus 17,392 (9543-43,145), P < .001. A 5000-unit increase in AUC<sub>0-28</sub> was associated with decreased mortality (OR 0.62, 95% CI 0.43-0.88, P = .008) and decreased composite safety events (OR 0.57, 95% CI 0.45-0.71, P < .001). Higher AUC<sub>0-28</sub> was associated with a greater probability of recovery; an AUC<sub>0-28</sub> ≤ 17,400 mg h/L was associated with a 3.45-fold higher (95% CI 2.23-5.34) probability of recovery at Day 28, as was an AUC<sub>0-28</sub> >17,400 mg h/L, albeit at a lower rate (1.18-fold higher [95% CI 1.07-1.32]), P < .002 for both. Overall, 113/390 (29.0%) patients did not achieve an optimal predicted infliximab AUC<sub>0-28</sub> of at least 17,400 mg h/L, particularly those <100 kg and those with the highest baseline disease severity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04593940.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250503","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: 0
Pharmacokinetics Analysis of Serum and Rectal Tissue Concentrations of a Pair of Anti-HIV Monoclonal Antibodies, VRC01 and VRC01LS, in Adults without HIV. 抗HIV单克隆抗体VRC01和VRC01LS在非HIV成人血清和直肠组织浓度的药动学分析
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-08 DOI: 10.1002/jcph.70060
Yunda Huang, Lily Zhang, Maria P Lemos, Rena D Astronomo, Sandeep Narpala, Madhu Prabhakaran, Nina Marie G Garcia, Yiwen Lu, Greg J Mize, Hayley Glantz, Hunter Colegrove, Philipp Mann, Carmen A Paez, Erica Andersen-Nissen, Julia Hutter, Julie Dumond, Adrian B McDermott, John R Mascola, Richard A Koup, Linda-Gail Bekker, M Juliana McElrath
{"title":"Pharmacokinetics Analysis of Serum and Rectal Tissue Concentrations of a Pair of Anti-HIV Monoclonal Antibodies, VRC01 and VRC01LS, in Adults without HIV.","authors":"Yunda Huang, Lily Zhang, Maria P Lemos, Rena D Astronomo, Sandeep Narpala, Madhu Prabhakaran, Nina Marie G Garcia, Yiwen Lu, Greg J Mize, Hayley Glantz, Hunter Colegrove, Philipp Mann, Carmen A Paez, Erica Andersen-Nissen, Julia Hutter, Julie Dumond, Adrian B McDermott, John R Mascola, Richard A Koup, Linda-Gail Bekker, M Juliana McElrath","doi":"10.1002/jcph.70060","DOIUrl":"https://doi.org/10.1002/jcph.70060","url":null,"abstract":"<p><p>VRC01 and VRC01LS are a pair of parental and LS-modified anti-HIV IgG1-backboned monoclonal antibodies. In a Phase 1 clinical trial HVTN 116, 79 participants without HIV received intravenously one dose of VRC01 (30 mg/kg, n = 16) or VRC01LS (30 mg/kg, n = 10), four doses of VRC01 (10 mg/kg, n = 23 or 30 mg/kg, n = 23) every 2 months, or three doses of VRC01LS (30 mg/kg, n = 7) every 3 months. Participants were followed for 6 (VRC01) or 12 (VRC01LS) months after the last dose. Using nonlinear mixed-effects models, we conducted the first population pharmacokinetics analysis of VRC01/LS concentrations in serum and rectal tissue, a primary site of HIV transmission. Serum concentration was described as a one-compartment model in equilibrium with one tissue compartment, with first-order elimination in both compartments. The model was parameterized with micro-constants to estimate volumes of distribution for serum and tissue, serum-tissue distribution rates (K12, K21), and elimination rate constants; distribution and elimination half-life estimates were derived from the governing differential equations. To account for rectal biopsy heterogenicity between individuals, three normalization approaches were used: tissue weight adjusted, IgG concentration adjusted, and protein concentration adjusted. All three approaches rendered consistent estimates. Based on protein-concentration-normalized data, VRC01LS (vs VRC01) exhibited ∼10-fold higher concentrations over time in blood and rectal tissues, and faster blood-to-tissue distribution (K12 = 0.61 vs 0.13/day). Median elimination half-life estimates were 20 days for VRC01 and 63 days for VRC01LS in serum and rectal tissues. These data support lower dosage and/or less frequent dosing of LS monoclonal antibodies providing potentially more immediate protection against HIV exposure in the rectum.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250514","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: 0
Assessment of the Effects of Fruquintinib on Cardiac Safety in Patients with Metastatic Colorectal Cancer. 氟喹替尼对转移性结直肠癌患者心脏安全性的影响评估。
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-08 DOI: 10.1002/jcph.70051
Xiaofei Zhou, Alice Toms, Dave Morton, Xiaohui Wang, Adekemi Taylor, Arvind Dasari, Neeraj Gupta, Caly Chien
{"title":"Assessment of the Effects of Fruquintinib on Cardiac Safety in Patients with Metastatic Colorectal Cancer.","authors":"Xiaofei Zhou, Alice Toms, Dave Morton, Xiaohui Wang, Adekemi Taylor, Arvind Dasari, Neeraj Gupta, Caly Chien","doi":"10.1002/jcph.70051","DOIUrl":"https://doi.org/10.1002/jcph.70051","url":null,"abstract":"<p><p>Fruquintinib is a highly selective oral inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, approved by the US Food and Drug Administration and the European Commission for the treatment of previously treated metastatic colorectal cancer (mCRC), regardless of biomarker status. This study used concentration QT interval (C-QTc) modeling, utilizing data from the phase 3 FRESCO-2 study (NCT04322539) in which patients with mCRC received fruquintinib 5 mg, once daily, or matching placebo in a 28-day cycle, to evaluate the potential of fruquintinib to delay cardiac repolarization. The primary objectives were to assess the relationship between change from baseline in the QTc and plasma concentrations of fruquintinib and its metabolite M11, and to predict placebo-corrected change from baseline in the corrected QT interval (ΔΔQTc) associated with clinically relevant fruquintinib or M11 concentrations. The C-QTc analysis was conducted using 1456 time-matched concentration-change from baseline in the population-based corrected QT interval (ΔQTcP) pairs from 205 patients (fruquintinib n = 137; placebo n = 68). The final C-QTc model was a linear mixed-effects model with the effect of M11 concentration on ΔQTcP. This model estimated that the upper bounds of the 90% CI of the mean ΔΔQTcP at steady-state geometric mean (GM) M11 C<sub>max,</sub> and twice the GM M11 C<sub>max</sub> were 0.0537 and 4.00 ms, respectively. Additional C-QTc analysis, including only fruquintinib concentrations, showed no relationship between ΔQTcP and fruquintinib concentrations. The analysis indicated that fruquintinib administered at the approved clinical dose is not anticipated to cause clinically meaningful QT prolongation.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250502","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: 0
Population Pharmacokinetic Modeling of Subcutaneous Plozasiran in Healthy Volunteers and Patients with Familial Chylomicronemia Syndrome, Severe Hypertriglyceridemia, and Mixed Hyperlipidemia. 健康志愿者和家族性乳糜微粒血症综合征、严重高甘油三酯血症和混合性高脂血症患者皮下普洛西兰的群体药代动力学模型
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-05 DOI: 10.1002/jcph.70055
James Ousey, Claudia Jomphe, Anh Ta, Nathalie H Gosselin, Jack Shi
{"title":"Population Pharmacokinetic Modeling of Subcutaneous Plozasiran in Healthy Volunteers and Patients with Familial Chylomicronemia Syndrome, Severe Hypertriglyceridemia, and Mixed Hyperlipidemia.","authors":"James Ousey, Claudia Jomphe, Anh Ta, Nathalie H Gosselin, Jack Shi","doi":"10.1002/jcph.70055","DOIUrl":"https://doi.org/10.1002/jcph.70055","url":null,"abstract":"<p><p>Plozasiran, a novel small interfering RNA therapeutic targeting the hepatic biosynthesis of apolipoprotein C-III, has successfully completed the pivotal Phase 3 trial for treatment of familial chylomicronemia syndrome. The Phase 3 trials of plozasiran conducted in patients with severe hypertriglyceridemia (SHTG) are currently ongoing. An integrated population pharmacokinetic (PPK) model was developed by combining plozasiran pharmacokinetic (PK) data from healthy volunteers and patients with varying severities of hypertriglyceridemia (HTG) enrolled in five clinical studies. Plozasiran plasma PK were described by dual first-order absorption kinetics following subcutaneous administration, a one-compartment model of systemic distribution, and a dose-linear, time-independent rate of clearance. Evaluation of covariates identified body weight (BW) and body mass index (BMI) as the only independent intrinsic factors to influence plozasiran PK with statistical significance, although without clinical importance. The PPK analysis supports a fixed dosage of plozasiran for all patients regardless of BW, BMI, sex, age, race (including the Asian population), differing severity of HTG, mild to moderate degrees of renal impairment, or a mild degree of hepatic impairment. As plozasiran PK were not differentiated by patient population, a substantially reduced schedule of PK sampling was justified for the ongoing Phase 3 studies to confirm the safety and efficacy of plozasiran in patients with SHTG. Model-based extrapolation of plozasiran concentrations in plasma and liver suggests that the plozasiran dosing regimen of 25 mg every 3 months recommended for adult patients is likely safe and effective in adolescent patients aged 12 to 17 years old.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227311","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: 0
Physiologically Based Pharmacokinetic/Pharmacodynamic Model for Secukinumab: Dose Exploration in Pediatric Patients with Plaque Psoriasis. 基于生理学的Secukinumab药代动力学/药效学模型:儿科斑块型银屑病患者的剂量探索
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-04 DOI: 10.1002/jcph.70056
Liu Zhiwei, Wang Wenhui, Chen Tao, Li Yiming, Chen Youjun, Wu Yating, Li Saiya, Xie Haitang
{"title":"Physiologically Based Pharmacokinetic/Pharmacodynamic Model for Secukinumab: Dose Exploration in Pediatric Patients with Plaque Psoriasis.","authors":"Liu Zhiwei, Wang Wenhui, Chen Tao, Li Yiming, Chen Youjun, Wu Yating, Li Saiya, Xie Haitang","doi":"10.1002/jcph.70056","DOIUrl":"https://doi.org/10.1002/jcph.70056","url":null,"abstract":"<p><p>Secukinumab has been widely applied in adults for the treatment of plaque psoriasis and psoriatic arthritis. However, there remains a knowledge gap in the dosing of secukinumab for pediatric patients with plaque psoriasis. This study aims to investigate the dosing regimen for pediatric patients aged 2 years and older. A physiologically based pharmacokinetic model for secukinumab was developed and validated in adult patients. Based on this model, two additional observation compartments for total interleukin-17A (IL-17A) and skin free IL-17A were incorporated to evaluate the inhibition of secukinumab on its targets. Ultimately, this model was extrapolated to pediatric patients. The model precisely captured the pharmacokinetic profiles and serum total IL-17A levels observed in different studies, encompassing various dosing schedules and formulations. Pediatric patients were stratified by weight, and the model incorporated age-related developmental factors. Using the inhibition of skin free IL-17A during steady-state treatment as a benchmark for a 300 mg adult dose indicates that pediatric patients weighing less than 25 kg require 75 mg, those weighing between 25 and 50 kg require 150 mg, and patients weighing more than 50 kg require 225 mg to achieve similar levels of inhibition. This conclusion provides new ideas for flexible medication use in pediatric patients with psoriasis.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217319","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: 0
Review of Clinical Pharmacology Information for Peptides Found in US FDA Drug Labeling. 美国FDA药物标签中肽类的临床药理学信息综述。
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-06-04 DOI: 10.1002/jcph.70047
Raajan Naik, Jie Wang, Lin Zhou, Anand Balakrishnan, Jeffry Florian, Rajanikanth Madabushi, Kimberly Maxfield, Anuradha Ramamoorthy, Martina Sahre, Yow-Ming Wang, Xinning Yang, Elimika Pfuma Fletcher
{"title":"Review of Clinical Pharmacology Information for Peptides Found in US FDA Drug Labeling.","authors":"Raajan Naik, Jie Wang, Lin Zhou, Anand Balakrishnan, Jeffry Florian, Rajanikanth Madabushi, Kimberly Maxfield, Anuradha Ramamoorthy, Martina Sahre, Yow-Ming Wang, Xinning Yang, Elimika Pfuma Fletcher","doi":"10.1002/jcph.70047","DOIUrl":"https://doi.org/10.1002/jcph.70047","url":null,"abstract":"<p><p>Peptides are oligomers with ≤40 amino acids and are regulated as small molecule drugs. Peptides can exhibit certain clinical pharmacology features characteristic of small molecule drugs and others characteristic of biologics. To inform best practices in clinical pharmacology, we reviewed general characteristics of peptides approved by US Food and Drug Administration before July 2022 and how often clinical pharmacology information, and corresponding recommendations were discussed in drug labeling. For peptides, clinical pharmacology information was available in the labeling related to renal impairment for 57% (30/53), drug-drug interactions for 49% (26/53), immunogenicity for 40% (21/53), hepatic impairment for 38% (20/53), QT interval assessment for 34% (18/53), and mass balance for 17% (9/53). Actionable clinical pharmacology recommendations found in labeling related to each survey topic were catalogued and included dose adjustments and risk mitigation strategies.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217320","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: 0
The Impact of Standard Versus Weight-Based Maintenance Dosing of Fosphenytoin on Achieving Therapeutic Drug Levels. 磷妥英的标准剂量与体重维持剂量对达到治疗药物水平的影响。
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-05-28 DOI: 10.1002/jcph.70050
Madison Milby, Theresa Kwarciany, Lindsey Jarboe, Lindsay Weitkamp
{"title":"The Impact of Standard Versus Weight-Based Maintenance Dosing of Fosphenytoin on Achieving Therapeutic Drug Levels.","authors":"Madison Milby, Theresa Kwarciany, Lindsey Jarboe, Lindsay Weitkamp","doi":"10.1002/jcph.70050","DOIUrl":"https://doi.org/10.1002/jcph.70050","url":null,"abstract":"<p><strong>Background: </strong>Fosphenytoin is an antiepileptic drug (AED) used for the treatment of many seizure subtypes as well as seizure prophylaxis. Dosing of fosphenytoin has traditionally been weight-based, however, there is data to support standard dosing, making the optimal dosing strategy unclear. The purpose of this study was to evaluate the impact of standard versus weight-based maintenance dosing of fosphenytoin on achieving therapeutic serum phenytoin levels.</p><p><strong>Methods: </strong>This was a retrospective review of patients admitted at two medical centers between January 1, 2021, and October 31, 2023 who received fosphenytoin maintenance therapy. Patients were divided into two groups based on initial maintenance dose: standard dosing (100 mg every 8 h) and weight-based dosing. The primary outcome was the incidence of the first serum phenytoin level being therapeutic.</p><p><strong>Results: </strong>A total of 92 patients with an average age of 56.9 years were included, 47 patients in the weight-based dosing group and 45 patients in the standard dosing group. The mean corrected total and free phenytoin levels were 12.8 and 1.6 mcg/mL respectively in the weight-based dosing group compared to 12.1 and 1.45 mcg/mL in the standard dosing group. A total of 32 patients in the weight-based dosing group had a therapeutic level compared to 25 patients in the standard dosing group, which was not significantly different (68% versus 55.6%, P =  0.283).</p><p><strong>Conclusion: </strong>This study found no difference in the incidence of first serum phenytoin level being therapeutic based on fosphenytoin dosing strategy utilized. Further prospective studies should be conducted to evaluate fosphenytoin maintenance dosing strategies.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175447","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: 0
The Pharmacokinetics, Pharmacodynamics, Tolerability, and Safety of Orally Dosed QY201, a Novel JAK1/TYK2 Inhibitor, in Chinese Healthy Subjects. 新型JAK1/TYK2抑制剂QY201在中国健康人体内的药代动力学、药效学、耐受性和安全性
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-05-27 DOI: 10.1002/jcph.70053
Jia-Ying Wang, Ying-Hui Gao, Zou-Rong Ruan, Dan-Dan Yang, Hua Li, Shi-da Qiao, Jian-Hui Li, Xin You, Jun Shi, Bo Jiang
{"title":"The Pharmacokinetics, Pharmacodynamics, Tolerability, and Safety of Orally Dosed QY201, a Novel JAK1/TYK2 Inhibitor, in Chinese Healthy Subjects.","authors":"Jia-Ying Wang, Ying-Hui Gao, Zou-Rong Ruan, Dan-Dan Yang, Hua Li, Shi-da Qiao, Jian-Hui Li, Xin You, Jun Shi, Bo Jiang","doi":"10.1002/jcph.70053","DOIUrl":"https://doi.org/10.1002/jcph.70053","url":null,"abstract":"<p><p>QY201 is a dual inhibitor targeting Janus Kinase 1/Tyrosine Kinase 2, developed for the treatment of atopic dermatitis and other autoimmune diseases. The pharmacokinetics (PK), pharmacodynamics (PD), tolerability, and safety of QY201 were assessed in a randomized, double-blind study in healthy subjects. Population PK and PD models were developed to characterize the PK and PD of QY201. QY201 was absorbed and eliminated rapidly, and the exposure was approximately dose-proportional over the 1-40 mg dose range, with no significant accumulation after repeated dosing. A high-fat meal reduced the maximum plasma concentration of QY201 by 40.7% but did not affect the area under the concentration-time curve. The fraction of the QY201 dose eliminated in the urine unchanged was 22%. In the multiple ascending-dose phase, the reduction of hypersensitive C-reactive protein (hsCRP) and absolute neutrophil count (ANC) showed dose-dependent trends within certain doses. The PK of QY201 was best described by a 2-compartment model with first-order absorption and elimination. The hsCRP was best described by an indirect response maximum drug effect (E<sub>max</sub>) model. QY201 was generally safe and well tolerated following oral administration, with dose-limiting toxicity of the highest tested dose of 40 mg being well tolerated. The favorable PK, PD, safety, and tolerability results from these studies supported evaluations of QY201 in future clinical trials.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163207","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: 0
Evaluation of Potential Adverse Effects of Gender-Affirming Hormonal Therapy; Findings from the Spanish Pharmacovigilance System Database. 性别肯定激素治疗潜在不良反应的评价来自西班牙药物警戒系统数据库的调查结果。
IF 2.9 4区 医学
Journal of Clinical Pharmacology Pub Date : 2025-05-27 DOI: 10.1002/jcph.70052
Elena María Pérez-López, Jorge Navarro Roldán, Luisa María Herrera Rojas, Carmen María Jiménez Martín, Mercedes Ruiz Pérez, María Nieves Merino Kolly, Asunción Mengíbar García, María Esperanza Segura Molina, Ana Francisca Melcón de Dios, Luis Miguel Calderón López, María Del Pilar Máiquez Asuero
{"title":"Evaluation of Potential Adverse Effects of Gender-Affirming Hormonal Therapy; Findings from the Spanish Pharmacovigilance System Database.","authors":"Elena María Pérez-López, Jorge Navarro Roldán, Luisa María Herrera Rojas, Carmen María Jiménez Martín, Mercedes Ruiz Pérez, María Nieves Merino Kolly, Asunción Mengíbar García, María Esperanza Segura Molina, Ana Francisca Melcón de Dios, Luis Miguel Calderón López, María Del Pilar Máiquez Asuero","doi":"10.1002/jcph.70052","DOIUrl":"https://doi.org/10.1002/jcph.70052","url":null,"abstract":"<p><p>The Spanish Pharmacovigilance System for Medicines for Human Use (SEFV-H) is responsible for recording and evaluating adverse reactions suspected to be due to medicines. The aim of this study was to review all reports of suspected adverse drug reactions (ADRs) in the SEFV-H database derived from the gender-affirming hormone therapy (GAHT). For this purpose, we consulted the Andalusian Centre for Pharmacovigilance (CAFV) and used three search algorithms to select only those reports derived from hormone therapy used by trangender people. A total of 21 reports were obtained, 13 corresponding to masculinizing therapy with testosterone and 8 corresponding to feminizing therapy with estradiol and cyproterone acetate. Most of these reports were of non-serious symptoms. Skin and subcutaneous tissue disorders, neoplasms, and psychiatric, vascular, gastrointestinal, and nervous system disorders were the most common suspected ADRs. The median age was 23.6 years for masculinizing therapy and 27 years for feminizing therapy. These data highlight the need for well-designed studies specifically focused on transgender people undergoing hormone therapy. Such studies are essential to develop evidence-based treatment guidelines tailored to this population and to provide accurate, population-specific information about the potential health risks associated with gender-affirming hormone use.</p>","PeriodicalId":48908,"journal":{"name":"Journal of Clinical Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152564","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}
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