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.
概括
高剂量里法辛在结核性脑膜炎 (TBM) 患者中没有改变德克萨米他的暴露. 药物相互作用,特别是lopinavir/ritonavir,在与HIV相关的TBM中显著增加了德甲清除.
科学领域:
- 药理动力学 药理动力学
- 传染性疾病 传染性疾病
- 艾滋病毒 医学 艾滋病毒 医学
背景情况:
- 德克萨米他是一种推的结核性脑膜炎 (TBM) 辅助疗法.
- 利芬素的同时使用可能会降低德克萨米他的暴露,这在临床试验中对更高的利芬素剂量造成了担忧.
研究的目的:
- 为了评估高剂量里法匹辛对艾滋病毒相关的TBM的成年人中德克萨梅他的药理学效应.
- 调查潜在的药物相互作用,影响TBM治疗期间的德克萨米他水平.
主要方法:
- 药理动力学研究嵌入了一个随机对照试验的高剂量与标准剂量里法西因在艾滋病毒相关的TBM.
- 在注册后的第3天测量了甲的度.
- 非线性混合效应建模用于分析德克萨米他的药理动力学.
主要成果:
- 观察到高甲清除率,与典型清除率 (131 L/h) 相比,同时使用洛皮纳维尔/里托纳维尔 (11.5 L/h) 显著降低.
- 与标准剂量里法辛相比,高剂量里法辛对德克萨米他的药理学参数没有显著的额外影响.
- 18%的参与者使用了基于efavirenz的ART,11%的参与者使用了lopinavir/ritonavir.
结论:
- 利芬素和与艾滋病毒相关的TBM治疗方案导致高德甲清除,可能是由于药物相互作用.
- 高剂量的利法素似乎没有进一步影响除了标准剂量的利法素和其他抗逆转录病毒药物的作用之外的德甲暴露.
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