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Steady state pharmacokinetics of piroxicam in children with rheumatic diseases
A L Mäkelä1, K T Olkkola, M J Mattila
1Department of Pediatrics, University Central Hospital, Turku, Finland.
Insights
Piroxicam pharmacokinetics in children with rheumatoid arthritis show higher clearance and shorter half-life compared to young adults. These findings are crucial for optimizing pediatric rheumatoid arthritis treatment.
Area of Science:
- Pharmacology
- Pediatric Rheumatology
Background:
- Rheumatoid arthritis (RA) affects children, necessitating effective pain and inflammation management.
- Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) used for RA, but its pharmacokinetic profile in pediatric populations requires further investigation.
Purpose of the Study:
- To characterize the pharmacokinetics of piroxicam in children diagnosed with rheumatoid arthritis.
- To compare piroxicam clearance, half-life, and volume of distribution in pediatric RA patients with existing data from young adults.
Main Methods:
- Ten children (aged 7-16 years) with RA received piroxicam (mean dose 0.4 mg/kg) once daily for two weeks.
- Blood samples were collected 2-120 hours after the final dose on Day 15 for pharmacokinetic analysis.
- Key parameters including Cmax, half-life, volume of distribution (V/F), and total body clearance (CL/F) were determined.
Main Results:
- Piroxicam Cmax ranged from 3.6 to 9.8 mg/L (mean 6.6 mg/L).
- The elimination half-life ranged from 22 to 40 hours (mean 32.6 hours).
- Volume of distribution (V/F) averaged 0.16 L/kg, and total body clearance (CL/F) averaged 3.4 mL/kg/h, indicating higher clearance and shorter half-life compared to young adults.
Conclusions:
- Piroxicam exhibits distinct pharmacokinetic properties in pediatric RA patients, characterized by increased clearance and reduced half-life relative to young adults.
- These findings suggest potential differences in drug metabolism and elimination in children, impacting dosing strategies.
- Further research is warranted to establish optimal piroxicam dosing regimens for effective and safe management of pediatric rheumatoid arthritis.
Abstract:
Ten children with rheumatoid arthritis, aged 7-16 y and weighing 20-63 kg, were treated with piroxicam mean dose 0.4 mg.kg-1 once daily for 2 weeks. On Day 15, blood was sampled from 2-120 h after the last dose. The Cmax for piroxicam ranged from 3.6 to 9.8 (mean 6.6) mg.l-1 and its half-life by log linear computation was 22 to 40 (mean 32.6) h. The volumes of distribution and the total body clearance were estimated as the ratio of actual volumes of distribution and actual clearances to availability. The volumes of distribution (V/F) were 0.12 to 0.25 (mean 0.16) l.kg-1, and the total body clearances (CL/F) were 2.1 to 5.0 (mean 3.4) ml.kg-1.h-1. Thus, piroxicam clearance in these patients was higher and its half-life was shorter than those previously reported in young adults, yet V appeared similar.