CLIN PHARMACOKINET:抗逆转录病毒药物和CYP2C9 / CYP2C19多态性对Etravirine药代动力学的影响?

2017-06-02 MedSci MedSci原创

Etravirine是一种非核苷逆转录酶抑制剂,与其他抗逆转录病毒药联合用于治疗≥6岁的艾滋病毒患者。Etravirine主要由细胞色素P450(CYP)2C9,CYP2C19和CYP3A代谢。该分析确定了伴随的抗逆转录病毒药物和CYP2C9 / CYP2C19表型对Etravirine的药代动力学的影响。

近日,国际杂志CLINICAL PHARMACOKINETICS上在线发表一项关于伴随抗逆转录病毒药物和CYP2C9 / CYP2C19多态性对Etravirine药代动力学的影响的研究。

Etravirine是一种非核苷逆转录酶抑制剂,与其他抗逆转录病毒药联合用于治疗≥6岁的艾滋病毒患者。Etravirine主要由细胞色素P450CYP2C9CYP2C19CYP3A代谢。该分析确定了伴随的抗逆转录病毒药物和CYP2C9 / CYP2C19表型对Etravirine的药代动力学的影响。

研究人员使用从4临床研究中收集的817名成年受试者中获得的4728血浆浓度来开发群体药代动力学模型。评估了atazanavir /ritonavir,洛匹那韦/利托那韦,地瑞那韦/利托那韦,替诺福韦地索普西富马酸盐或恩夫韦地与CYP2C9CYP2C19表型以及其他人口统计学的关系。

研究数据经具有一阶输入和滞后时间的单室模型进行描述。表观总清除率(CL / F),表观中心分布体积(V c / F),一级吸收速率常数(k a)和吸收滞后时间的估计值分别为41.7 L / h972 L1.16 h ,和1.32小时。CL / FV c / F和相对生物利用度(F)之间的受试者间变异性的估计分别为39.4CV(百分比变异系数),35.9CV35.5CVF之间的时间变异性估计为30.0CVCL / F与体重和肌酐清除率(CL CR)呈非线性增加,也随着CYP2C9 / CYP2C19表型变化。

在此分析中,发现体重,CL CRCYP2C9 / CYP2C19表型能够解释CL/F的一些变异。但不可能解释伴随抗逆转录病毒药物对主要服用共同给药的增强蛋白酶抑制剂作为背景抗逆转录病毒方案的成人Etravirine的药代动力学的影响。

原始出处:

Bruce Green, Herta Crauwels, Thomas N. et.al. Evaluation of Concomitant Antiretrovirals and CYP2C9/CYP2C19 Polymorphisms on the Pharmacokinetics of Etravirine. Clin Pharmacokinet (2017) 56: 525.

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    2017-09-30 canlab
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objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Nov 23 05:02:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656796, encodeId=184b1656e962d, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Fri Aug 11 04:02:00 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978140, encodeId=266419e814001, content=<a href='/topic/show?id=8253556960' target=_blank style='color:#2F92EE;'>#CYP2C9#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5569, encryptionId=8253556960, topicName=CYP2C9)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Feb 10 20:02:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1933934, encodeId=4fc81933934eb, content=<a href='/topic/show?id=aa17556681' target=_blank style='color:#2F92EE;'>#CYP2C19#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5566, encryptionId=aa17556681, topicName=CYP2C19)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Mar 09 02:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747244, encodeId=90681e47244d2, content=<a href='/topic/show?id=832e93345c3' target=_blank style='color:#2F92EE;'>#转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93345, encryptionId=832e93345c3, topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Thu Mar 01 08:02:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
    2017-12-22 hxj0117
  5. [GetPortalCommentsPageByObjectIdResponse(id=1632289, encodeId=032c1632289c9, content=<a href='/topic/show?id=8d51558114f' target=_blank style='color:#2F92EE;'>#抗逆转录病毒药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55811, encryptionId=8d51558114f, topicName=抗逆转录病毒药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd3921890223, createdName=venlin, createdTime=Tue Jan 30 08:02:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1733873, encodeId=f7241e3387385, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, 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content=<a href='/topic/show?id=8253556960' target=_blank style='color:#2F92EE;'>#CYP2C9#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5569, encryptionId=8253556960, topicName=CYP2C9)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Feb 10 20:02:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1933934, encodeId=4fc81933934eb, content=<a href='/topic/show?id=aa17556681' target=_blank style='color:#2F92EE;'>#CYP2C19#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5566, encryptionId=aa17556681, topicName=CYP2C19)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Mar 09 02:02:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747244, encodeId=90681e47244d2, content=<a href='/topic/show?id=832e93345c3' target=_blank style='color:#2F92EE;'>#转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93345, encryptionId=832e93345c3, topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Thu Mar 01 08:02:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
    2017-07-12 yb6560
  6. [GetPortalCommentsPageByObjectIdResponse(id=1632289, encodeId=032c1632289c9, content=<a href='/topic/show?id=8d51558114f' target=_blank style='color:#2F92EE;'>#抗逆转录病毒药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55811, encryptionId=8d51558114f, topicName=抗逆转录病毒药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd3921890223, createdName=venlin, createdTime=Tue Jan 30 08:02:00 CST 2018, time=2018-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1733873, encodeId=f7241e3387385, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747244, encodeId=90681e47244d2, content=<a href='/topic/show?id=832e93345c3' target=_blank style='color:#2F92EE;'>#转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93345, encryptionId=832e93345c3, topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Thu Mar 01 08:02:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747244, encodeId=90681e47244d2, content=<a href='/topic/show?id=832e93345c3' target=_blank style='color:#2F92EE;'>#转录#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93345, encryptionId=832e93345c3, topicName=转录)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58df35929710, createdName=mjldent, createdTime=Thu Mar 01 08:02:00 CST 2018, time=2018-03-01, status=1, ipAttribution=)]
    2017-08-11 bsmagic9140
  8. 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  9. 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    2018-03-09 30397604
  10. 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    2018-03-01 mjldent

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对于抗逆转录病毒药物(ARVs)的使用建议需要更新新的数据和治疗方案以治疗或预防成年人感染艾滋病毒。本研究旨在为感染HIV的成年人(年龄≥18年)提供最新的抗逆转录病毒治疗方法,包括何时开始治疗,初始治疗方案,改变方案,以及使用抗逆转录病毒药物预防高危人群感染HIV,包括暴露前和暴露后的预防。国际抗病毒协会召开了会议,HIV研究和病人护理的专家小组审查了2014年以来发表在同行评审期刊上的新的研究

世卫组织将修改抗艾指导方针

世界卫生组织(WHO)日前表示,它将建议每一个艾滋病病毒(HIV)感染者在诊断后应尽早使用抗逆转录病毒(ARV)药物进行治疗—— 一系列令人信服的试验已经证明了早期治疗的益处。该组织在加拿大温哥华召开的国际艾滋病(AIDS)协会(IAS)年会的一场卫星会议上,讨论了被广泛预期的改变其现有指导方针的计划,与此同时,研究人员还在此次IAS年会上公布了来自ARV治疗试验的鼓舞人心的最新结果。WHO下属H

Pediatr Infect Dis J:孕期抗逆转录病毒治疗与小于胎龄儿

世界上每天大约有1500名儿童感染艾滋病毒,其中大部分是在母亲怀孕和分娩时被感染的新生胎儿。通常HIV孕妇可以使用抗逆转录病毒(ARV)治疗以最大限度的减少垂直传播风险。先前有研究报道孕期抗逆转录病毒(ARV)治疗和小于胎龄儿(SGA)间有着某种关系,但目前的报道均不能完全阐明该联系。因此Phiri K等人收集了田纳西州相关医学记录,纳入1994-2009年间HIV孕妇。根据诊断、ARV处方、CD