A Multi-Center Evaluation of the Pharmacokinetics and Safety of Intravenous Ibuprofen in Infants 1-6 Months of Age.

IF 3.4 3区 医学 Q1 PEDIATRICS Pediatric Drugs Pub Date : 2023-09-01 DOI:10.1007/s40272-023-00576-9
Chris D Glover, John W Berkenbosch, Mary B Taylor, Nihar V Patel, Byron Kaelin, Breanne H Y Gibson, John Zhong
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Abstract

Background: Enteral ibuprofen was first approved as a prescription drug in 1974 for the US market. An intravenous (IV) ibuprofen formulation is approved for use in children older than 6 months of age, but there are limited studies specifically evaluating the pharmacokinetics and safety in children 1-6 months of age.

Aims: The primary purpose of this study was to evaluate the pharmacokinetics of IV ibuprofen in infants younger than 6 months of age. The secondary objective was to evaluate the safety of single and repeated doses of IV ibuprofen in infants younger than 6 months of age.

Methods: This was an industry-sponsored multi-center study. Institutional Review Board approval and informed parental consent were obtained prior to enrollment. Hospitalized neonates and infants younger than 6 months of age with fever or expected postoperative pain were eligible. Enrolled patients received 10 mg/kg of IV ibuprofen every 6 h, with up to four doses per day. Patients were randomized to two sparse sampling technique pharmacokinetic sample time groups. Group 1 samples were drawn at 0, 30 min, and 2 h, while group 2 samples were drawn at 0 min, 1, and 4 h after administration.

Results: A total of 24 children were enrolled in the study, with 15 male patients and 9 female patients. The median age of the cohort was 4.4 months (range 1.1-5.9 months), and the median weight was 5.9 kg (range 2.3-8.8 kg). The arithmetic mean and standard error for peak plasma ibuprofen concentration was 56.28 ± 2.77 µg/mL. Plasma levels declined rapidly with a mean elimination half-life of 1.30 h. Time to peak ibuprofen effect and concentration were similar when compared with older pediatric patients. Clearance and volume of distribution were also similar to those reported in older pediatric patients. No drug-related adverse events were reported.

Conclusions: The pharmacokinetic and short-term safety profiles of IV ibuprofen in pediatric patients 1-6 months of age are comparable to those in children older than 6 months of age.

Trial registration: Clinicaltrials.gov Trial Registration number and date: NCT02583399-Registered July 2017.

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1-6月龄婴儿静脉注射布洛芬药代动力学及安全性的多中心评价。
背景:肠内布洛芬于1974年首次被批准作为处方药在美国市场上市。静脉注射(IV)布洛芬制剂已被批准用于6个月以上的儿童,但专门评估1-6个月儿童的药代动力学和安全性的研究有限。目的:本研究的主要目的是评估静脉注射布洛芬在6个月以下婴儿中的药代动力学。次要目的是评估6个月以下婴儿单次和多次静脉注射布洛芬的安全性。方法:这是一项行业赞助的多中心研究。在入组前获得机构审查委员会的批准和家长的知情同意。住院的新生儿和小于6个月的婴儿有发烧或预期的术后疼痛。入组患者每6小时接受10 mg/kg静脉注射布洛芬,每天最多4次。将患者随机分为两个稀疏采样技术药代动力学采样时间组。组1分别于给药后0、30 min、2 h抽取,组2分别于给药后0 min、1、4 h抽取。结果:共有24名儿童入组,其中男15例,女9例。该队列的中位年龄为4.4个月(1.1-5.9个月),中位体重为5.9公斤(2.3-8.8公斤)。布洛芬血药浓度的算术平均值和标准误差为56.28±2.77µg/mL。血浆水平迅速下降,平均消除半衰期为1.30小时。与年龄较大的儿科患者相比,布洛芬效果和浓度达到峰值的时间相似。清除率和分布量也与老年儿科患者相似。无药物相关不良事件报告。结论:1-6月龄儿童IV布洛芬的药代动力学和短期安全性与6月龄以上儿童相当。试验注册:Clinicaltrials.gov试验注册号和日期:nct02583399 -注册于2017年7月。
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来源期刊
Pediatric Drugs
Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY
CiteScore
7.20
自引率
0.00%
发文量
54
审稿时长
>12 weeks
期刊介绍: Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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