中国 COVID-19 患者服用尼尔马特韦的群体药代动力学和药效学。

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY

Fundamental & Clinical Pharmacology Pub Date : 2024-02-11 DOI:10.1111/fcp.12989

Liyan Zeng, Rui Chen, Xuhua Jiang, Feng Li, Zhaoqin Zhu, Zheng Jiao, Yun Ling, Lijun Zhang

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引用次数: 0

摘要

背景：中国COVID-19患者的药代动力学（PK）和药效学（PD）特征尚不清楚：在中国的COVID-19患者中，nirmatrelvir（NMV）的药代动力学（PK）和药效学（PD）特征尚不清楚：目的：了解NMV的PK以及PK-PD特征，以优化COVID-19中国患者的剂量：方法：我们招募了141名参与者，他们接受了NMV 300 mg/ritonavir (RTV) 100 mg b.i.d.治疗，共5天。对251份血样进行了NMV浓度分析。采用非线性混合效应模型对这些 COVID-19 患者的 NMV PK/PD 进行了研究：结果：患者的平均年龄为 82 岁（34-97 岁）。中国患者对 NMV 的吸收率常数和表观清除率分别为 0.253 h-1 和 6.83 L/h，与白种人相似。没有协变量影响 NMV 的清除率。在 300 毫克 NMV/100 毫克 RTV 条件下，预测的峰浓度（Cmax）和谷浓度（Cmin）分别为 4004 纳克/毫升和 1498 纳克/毫升。虽然较高的AUC和Cmin与病毒基因周期阈值（CT）的轻微增加有微弱关联，但没有发现显著的相关性，表明药物暴露与疗效（CT）之间的关系不大：总之，我们的研究结果表明，没有种族间的 PK 差异，药物暴露量与疗效之间的关系较弱且在临床上不显著，根据 PK 参数确定适合中国患者（包括老年人）的剂量，由于个体间的差异性，需要进一步研究确定高危患者的最佳治疗方案。

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Population pharmacokinetics and pharmacodynamics of nirmatrelvir in Chinese patients with COVID-19

Background

The pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of nirmatrelvir (NMV) are unknown in Chinese patients with COVID-19.

Objectives

To understand the PK, as well as PK–PD characteristics of NMV for optimizing the dose in Chinese patients with COVID-19.

Methods

We enrolled 141 participants who received NMV 300 mg/ritonavir (RTV) 100 mg b.i.d. for 5 days. The NMV concentrations were analyzed using 251 blood samples. PK/PD of NMV was investigated in these COVID-19 patients using a nonlinear mixed-effects model.

Results

The patients had a mean age of 82 years (range, 34–97). The absorption rate constant and apparent clearance of NMV in this Chinese cohort were 0.253 h⁻¹ and 6.83 L/h, respectively, similar to Caucasian patients. No covariates affected NMV clearance. Predicted peak (C_max) and trough concentration (C_min) under 300 mg NMV/100 mg RTV b.i.d. were 4004 and 1498 ng/mL, respectively. Although higher AUC and C_min were weakly associated with a slight increase in the number of cycle threshold (CT) of viral genes, no significant correlation was found, indicating a weak relationship between drug exposure and efficacy (CT).

Conclusions

In all, our findings suggest no ethnic PK differences, a weak and clinically insignificant relationship between drug exposure and efficacy, suitable dosage for Chinese patients (including the elderly) based on PK parameters, and the need for further studies to determine optimal regimens for high-risk patients due to inter-individual variability.

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来源期刊

Fundamental & Clinical Pharmacology 医学-药学

CiteScore

5.30

自引率

6.90%

发文量

111

审稿时长

6-12 weeks

期刊介绍： Fundamental & Clinical Pharmacology publishes reports describing important and novel developments in fundamental as well as clinical research relevant to drug therapy. Original articles, short communications and reviews are published on all aspects of experimental and clinical pharmacology including: Antimicrobial, Antiviral Agents Autonomic Pharmacology Cardiovascular Pharmacology Cellular Pharmacology Clinical Trials Endocrinopharmacology Gene Therapy Inflammation, Immunopharmacology Lipids, Atherosclerosis Liver and G-I Tract Pharmacology Metabolism, Pharmacokinetics Neuropharmacology Neuropsychopharmacology Oncopharmacology Pediatric Pharmacology Development Pharmacoeconomics Pharmacoepidemiology Pharmacogenetics, Pharmacogenomics Pharmacovigilance Pulmonary Pharmacology Receptors, Signal Transduction Renal Pharmacology Thrombosis and Hemostasis Toxicopharmacology Clinical research, including clinical studies and clinical trials, may cover disciplines such as pharmacokinetics, pharmacodynamics, pharmacovigilance, pharmacoepidemiology, pharmacogenomics and pharmacoeconomics. Basic research articles from fields such as physiology and molecular biology which contribute to an understanding of drug therapy are also welcomed.