简要报告:多卢特格拉维尔血蛋白结合和未结合度在怀孕和产后期间
Jeremiah D Momper1, Mina Nikanjam2, Brookie M Best1,2
1Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA.
Journal of acquired immune deficiency syndromes (1999)
|October 26, 2023
概括
怀孕减少了多卢特格拉维尔 (DTG) 蛋白质的结合,导致第三个三个月和产后的DTG未结合水平相似. 这一发现对于了解艾滋病毒感染孕妇的DTG药理动力学至关重要.
科学领域:
- 药理动力学和药物新陈代谢
- 传染病和艾滋病毒/艾滋病
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 在怀孕期间降低多洛特格拉维尔 (DTG) 度的临床解释是具有挑战性的,因为蛋白质结合性很高.
- 怀孕期间血蛋白水平显著下降,影响药物的药理动力学.
- 了解DTG蛋白结合变化对于评估其在孕妇中治疗功效至关重要.
研究的目的:
- 评估怀孕期间杜洛特格拉维尔 (DTG) 蛋白结合和未结合度的变化.
- 为了评估怀孕对DTG药理动学的影响.
- 为了比较第二季度,第三季度和产后期之间的未结合的DTG水平.
主要方法:
- 从接受DTG的艾滋病毒感染孕妇的血样本进行回顾性分析.
- 在前剂量 (C0) 和最大 (Cmax) 点测量未结合和总DTG度.
- 在第二季度 (2T),第三季度 (3T) 和产后 (PP) 期间确定DTG度.
主要成果:
- 包括29名母亲;15名 (2T),27名 (3T) 和23名 (PP) 提供了用于蛋白质结合评估的样本.
- 与产后 (PP) 相比,DTG未结合的百分比在第三季度 (3T) 显著高于C0 (1.02%对0.69%) 和Cmax (0.76%对0.46%).
- 在C0的中位数未结合的DTG度在第二季度 (2T) 和分娩后 (PP) (6.3与13.3 ng/mL) 之间有显著差异,但在3T和PP之间没有 (8.0与13.3 ng/mL).
结论:
- 怀孕期间较低的DTG总血度与蛋白质结合的减少有关.
- 未结合的DTG度在第三个三个月和产后期间之间仍然可比.
- 这些发现对于优化DTG剂量和确保HIV感染的孕妇的治疗效果至关重要.
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