Iroko Pharmaceuticals, Philadelphia, PA, USA.
Postgrad Med. 2012 Jan;124(1):117-23. doi: 10.3810/pgm.2012.01.2524.
There is a clinical need for new nonsteroidal anti-inflammatory drugs (NSAIDs) and/or new formulations that, at minimum, retain the established efficacy of standard NSAIDs while minimizing their associated adverse events. This phase 1 clinical trial characterizes the pharmacokinetic (PK) profile of an investigational, proprietary, nano-formulated, lower-dose oral diclofenac (nano-formulated diclofenac) compared with oral diclofenac in healthy subjects.
A single-center, single-dose, randomized, open-label, 5-period, 5-treatment, 10-sequence crossover study was completed in 30 healthy subjects. Subjects received either nano-formulated diclofenac 18 mg or 35 mg or diclofenac 50 mg in fed and fasting states. The maximum measured plasma concentration (Cmax), time to maximum measured concentration (Tmax), terminal elimination half-life (T1/2), and area under the concentration time curve (AUC), along with safety and tolerability, were assessed.
Mean (± standard deviation) Tmax for nano-formulated diclofenac 18 (0.62 ± 0.35 h) and 35 mg (0.59 ± 0.20 h) demonstrated faster absorption than diclofenac 50 mg (0.80 ± 0.50 h). The T1/2 was similar between nano-formulated diclofenac 35 mg and diclofenac 50 mg (1.85 ± 0.45 h vs 1.92 ± 0.38 h, respectively). The Cmax for nano-formulated diclofenac 35 mg and diclofenac 50 mg was comparable in fasted subjects (1347 ± 764 ng/mL vs 1316 ± 577 ng/mL, respectively), but lower in fed subjects (524 ± 222 ng/mL vs 951 ± 391 ng/mL, respectively). As anticipated, there was a 19% reduction in drug exposure (AUC0(-∞)) when subjects received nano-formulated diclofenac 35 mg compared with diclofenac 50 mg under fasting conditions (1225 ± 322 hng/mL vs 1511 ± 389 hng/mL, respectively). Safety and tolerability were comparable between nano-formulated diclofenac and diclofenac.
The novel nano-formulated, lower-dose diclofenac demonstrated lower systemic exposure, comparable Cmax, and faster absorption compared with diclofenac. In light of the advisory issued by worldwide regulatory agencies regarding use of lowest effective doses, these data may permit use of lower NSAID doses that improve safety and tolerability while, at minimum, relieving pain similar to standard formulations.
临床需要新的非甾体抗炎药(NSAIDs)和/或新制剂,这些药物至少应保持标准 NSAIDs 的既定疗效,同时最大限度地减少其相关的不良事件。这项 1 期临床试验描述了一种研究性、专有的、纳米制剂、低剂量口服双氯芬酸(纳米制剂双氯芬酸)与健康受试者口服双氯芬酸的药代动力学(PK)特征。
在 30 名健康受试者中完成了一项单中心、单剂量、随机、开放标签、5 期、5 种治疗、10 种序列交叉研究。受试者分别在进食和禁食状态下服用纳米制剂双氯芬酸 18mg 或 35mg 或双氯芬酸 50mg。评估了最大实测血浆浓度(Cmax)、达峰时间(Tmax)、末端消除半衰期(T1/2)、浓度时间曲线下面积(AUC)以及安全性和耐受性。
纳米制剂双氯芬酸 18mg(0.62 ± 0.35 h)和 35mg(0.59 ± 0.20 h)的平均(±标准差)Tmax 表明吸收速度快于双氯芬酸 50mg(0.80 ± 0.50 h)。纳米制剂双氯芬酸 35mg 和双氯芬酸 50mg 的 T1/2 相似(分别为 1.85 ± 0.45 h 和 1.92 ± 0.38 h)。空腹受试者中,纳米制剂双氯芬酸 35mg 和双氯芬酸 50mg 的 Cmax 相当(分别为 1347 ± 764 ng/ml 和 1316 ± 577 ng/ml),但在进食状态下较低(分别为 524 ± 222 ng/ml 和 951 ± 391 ng/ml)。预期在禁食条件下,与双氯芬酸 50mg 相比,受试者接受纳米制剂双氯芬酸 35mg 时药物暴露(AUC0(-∞))降低 19%(分别为 1225 ± 322 hng/ml 和 1511 ± 389 hng/ml)。纳米制剂双氯芬酸与双氯芬酸的安全性和耐受性相当。
新型纳米制剂、低剂量双氯芬酸显示出较低的全身暴露量,与双氯芬酸相比,Cmax 相当,吸收速度更快。鉴于全球监管机构发布的关于使用最低有效剂量的咨询意见,这些数据可能允许使用较低的 NSAID 剂量,从而提高安全性和耐受性,同时至少缓解与标准制剂相似的疼痛。