中国健康受试者特戈普拉赞与克拉霉素、阿莫西林和铋剂复方制剂之间的药代动力学相互作用:一项开放标签、单中心、多剂量、自我控制的 I 期试验

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Clinical Drug Investigation Pub Date : 2024-04-13 DOI:10.1007/s40261-024-01359-x
Yujing Du, Lixiu Yu, Bin Deng, Qinying Li, Junrui Hu, Linjie Li, Yusen Xu, Liangwei Song, Fang Xie, Yinghui Wang, Yuhao Chen, Chengxin Liu, Xuejia Zhai, Yongning Lu
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引用次数: 0

摘要

背景特戈普拉赞是一种钾竞争性胃酸阻滞剂,能抑制胃酸,可用于根除幽门螺旋杆菌。本研究主要探讨特戈普拉赞与克拉霉素、阿莫西林和铋剂复方制剂在中国健康受试者中的药代动力学相互作用及安全性。方法在 22 名健康受试者中进行了一项开放标签、三期、单中心、多剂量、单序的 I 期试验。在第一阶段,受试者服用特戈普拉赞 50 毫克,每天两次,共 7 天;在第二阶段,受试者服用克拉霉素 500 毫克、阿莫西林 1000 毫克和枸橼酸铋钾 600 毫克,每天两次,共 7 天(第 14-20 天)。然后,在第 3 期中联合使用替戈普拉赞、克拉霉素、阿莫西林和枸橼酸铋钾,共 7 天(第 21-27 天)。在每个疗程的最后一次用药后 12 小时内采集血液样本。结果 稳定状态下最大血浆浓度(Cmax,ss)和给药间隔血浆浓度-时间曲线下面积(AUCτ)的几何平均比(GMRs)[90%置信区间(CI)]分别为 195.分别为195.93% (175.52-218.71%)和287.54% (263.28-314.04%);替戈普拉赞代谢物M1分别为423.23% (382.57-468.22%)和385.61% (354.62-419.30%)。克拉霉素的 Cmax、ss 和 AUCτ 的 GMRs(90% CI)分别为 83.69%(77.44-90.45%)和 110.30%(102.74-118.41%),14-羟基克拉霉素的 Cmax、ss 和 AUCτ 的 GMRs(90% CI)分别为 126.25%(114.73-138.93%)和 146.94%(135.33-159.55%)。55%),阿莫西林分别为 75.89%(69.73-82.60%)和 94.34%(87.94-101.20%),铋剂分别为 158.43%(125.43-200.11%)和 183.63%(156.42-215.58%)。所有报告的不良反应均为轻微。结论联合应用替戈普拉嗪、克拉霉素、阿莫西林和铋剂后,替戈普拉嗪、M1、14-羟基克拉霉素和铋剂的血浆暴露量增加。联合用药具有良好的安全性和耐受性。
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Pharmacokinetic Interactions Between Tegoprazan and the Combination of Clarithromycin, Amoxicillin and Bismuth in Healthy Chinese Subjects: An Open-Label, Single-Center, Multiple-Dosage, Self-Controlled, Phase I Trial

Background

Tegoprazan is a potassium-competitive acid blocker that inhibits gastric acid and which may be used for eradicating Helicobacter pylori. This study focuses on the pharmacokinetic interaction and safety between tegoprazan and the combination of clarithromycin, amoxicillin and bismuth in healthy Chinese subjects.

Methods

An open-label, three-period, single-center, multiple-dosage, single-sequence, phase I trial was conducted in 22 healthy subjects. In period 1, the subjects took tegoprazan 50 mg twice daily for 7 days, and in period 2 they were administered clarithromycin 500 mg, amoxicillin 1000 mg and bismuth potassium citrate 600 mg twice daily for 7 days (days 14–20). Tegoprazan, clarithromycin, amoxicillin and bismuth potassium citrate were then administered in combination for 7 days (days 21–27) in period 3. Blood samples were collected up to 12 h after the last dose of each period. Safety assessments were performed in each period.

Results

The geometric mean ratios (GMRs) [90% confidence interval (CI)] of maximum plasma concentration at steady state (Cmax,ss) and area under the plasma concentration–time curve over the dosing interval (AUCτ) at steady state were 195.93% (175.52–218.71%) and 287.54% (263.28–314.04%) for tegoprazan and 423.23% (382.57–468.22%) and 385.61% (354.62–419.30%) for tegoprazan metabolite M1, respectively. The GMRs (90% CI) of Cmax,ss and AUCτ were 83.69% (77.44–90.45%) and 110.30% (102.74–118.41%) for clarithromycin, 126.25% (114.73–138.93%) and 146.94% (135.33–159.55%) for 14-hydroxyclarithromycin, 75.89% (69.73–82.60%) and 94.34% (87.94–101.20%) for amoxicillin, and 158.43% (125.43–200.11%) and 183.63% (156.42–215.58%) for bismuth, respectively. All reported adverse events were mild. The frequency of adverse events during the coadministration stage was not higher than that during the single- or triple-drug administration stages.

Conclusion

The plasma exposure of tegoprazan, M1, 14-hydroxyclarithromycin and bismuth was increased after the coadministration of tegoprazan, clarithromycin, amoxicillin and bismuth. The coadministration exhibited favorable safety and tolerability.

Clinical Trials Registration

CTR20230643.

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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. 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 Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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