在结核性脑膜炎中使用德克萨米他的药理动力学
Jose M Calderin1, Juan Eduardo Resendiz-Galvan1, Noha Abdelgawad1
1Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Observatory, Cape Town, South Africa.
利芬素显著增加了与艾滋病毒相关的结核性脑膜炎 (TBM) 中的德克萨米他清除. 高剂量里法辛并没有进一步影响德克萨米他的暴露,这表明其他因素,如抗逆转录病毒疗法影响药物水平.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病病毒/艾滋病病毒
背景情况:
- 德克萨米他对于治疗结核性脑膜炎 (TBM) 是至关重要的.
- 同时服用利芬素可能会降低德克萨米他的有效性.
- 在临床试验中,正在研究更高的利芬素剂量.
研究的目的:
- 为了研究艾滋病毒相关的TBM的成年人中德克萨米他的药理学.
- 为了评估高剂量里法辛对德克萨米他暴露的影响.
- 在这个人群中确定影响德克萨米他清除的因素.
主要方法:
- 在随机对照试验中嵌入的药理动力学研究.
- 在第3天测量了甲的血度.
- 利用非线性混合效应建模进行分析.
主要成果:
- 观察到高德克萨米他清除率,可能是由于与利芬素的药物相互作用.
- 同时使用lopinavir/ritonavir显著降低了德克萨梅他的口服清除.
- 与标准剂量相比,高剂量里法西因对德克萨米他的药理动力没有显著的额外影响.
结论:
- 利芬素显著增加了与艾滋病毒相关的TBM中德克萨米他清除.
- 药物相互作用,特别是抗逆转录病毒疗法,是德克萨米他暴露的关键决定因素.
- 高剂量的利法素不会加剧利法素降低德甲的作用.
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