H2-受体对抗剂对达科米替尼布暴露的影响
Jian Liu1, Swan Lin2, Anthony Huynh3
1Clinical Pharmacology, Pfizer Investment Co., Ltd., Beijing 100010, China.
Pharmaceutics
|January 23, 2024
概括
组胺-2受体对抗剂 (H2RAs) 在晚期非小细胞肺癌 (NSCLC) 患者中不会显著改变达科米替尼布的暴露. 这一发现支持H2RAs与达科米替尼布的同时使用,这对于管理NSCLC至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 在瘤学瘤学.
- 药物相互作用 药物相互作用
背景情况:
- 达科米替尼 (dacomitinib) 是一种不可逆转的EGFR氨酸激酶抑制剂,用于治疗具有EGFR突变的晚期非小细胞肺癌 (NSCLC).
- 之前的研究表明质子抑制剂可以减少达科米替尼布的暴露.
- 历史胺-2受体对抗剂 (H2RAs) 对达科米替尼布暴露的影响需要进一步研究.
研究的目的:
- 评估H2RAs对NSCLC患者达科米替尼布暴露的影响.
- 评估达科米替尼和H2RAs之间的潜在药物相互作用的临床相关性.
主要方法:
- 患者内部分析比较了达科米提尼布及其代谢物与H2RAs和没有H2RAs的平稳状态低度 (Ctrough,ss).
- 用线性混合效应模型分析了在NSCLC患者中进行的11项临床研究的数据.
- 开发了一种基于生理学的药理动力学 (PBPK) 模型,以模拟H2RA诱导的胃pH值变化对达科米替尼的药理动力学的影响.
主要成果:
- 与H2RAs同时使用导致调整后的几何平均Ctrough,ss值为86% (原始药物),104% (代谢物) 和100% (活性部分),相对于单独使用达科米替尼布 (p>0.05).
- 在使用H2RA时,PBPK建模表明达科米提尼布最大度 (Cmax) 和曲线下面积 (AUC) 的变化微不足道.
- 统计分析显示,当与H2RAs同时使用时,达科米替尼布暴露没有显著差异.
结论:
- 同时使用H2RAs与达科米替尼布预计不会对达科米替尼布暴露产生临床显著影响.
- 这些发现支持H2RAs和dacomitinib在NSCLC患者的同时使用.
- 该研究提供了有价值的药理动力学数据,用于管理与降酸剂结合的达科米提尼布治疗.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
485
Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
485
Drug-Receptor Interaction: Antagonist
2.9K
An antagonist is a drug that binds strongly to a receptor without activating it. An antagonist prevents other molecules, such as neurotransmitters or hormones, from binding to the receptor and triggering a cellular response. Such interaction effectively hinders the normal physiological processes mediated by the receptor, resulting in various pharmacological effects depending on the specific receptor targeted.
Antagonists can be classified as competitive or noncompetitive based on their...
Antagonists can be classified as competitive or noncompetitive based on their...
2.9K
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
525
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
525
Drug-Receptor Interactions
5.2K
Drug-receptor interaction describes the binding of receptors by drugs, but not all drug-receptor interactions result in activation and tissue response. For instance, the binding of agonists activates the receptor to generate a cellular reaction, while antagonists bind to receptors without causing their activation.
Several parameters, such as the drug's affinity for its receptor and its efficacy, which is its ability to activate the receptor, determine the drug's effect on the tissue....
Several parameters, such as the drug's affinity for its receptor and its efficacy, which is its ability to activate the receptor, determine the drug's effect on the tissue....
5.2K
Antihypertensive Drugs: Direct Renin Inhibitors
631
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
631


