Shuying Yang1,2, Laurie Lee3, Steven Pascoe4. 1. GSK, Respiratory Medicines Development Centre, Stockley Park, Middlesex, UK. shuying.y.yang@gsk.com. 2. Clinical Pharmacology, Modelling and Simulation, R&D Projects Clinical Platforms and Sciences, GSK, Stockley Park West, 1-3 Iron Bridge Road, Uxbridge, Middlesex, UB11 1BT, UK. shuying.y.yang@gsk.com. 3. GSK, Respiratory Medicines Development Centre, Stevenage, UK. 4. GSK, Respiratory Medicines Development Center, Research Triangle Park, NC, 27709-3398, USA.
Abstract
BACKGROUND:Umeclidinium (UMEC; a long-acting anti-muscarinic) in combination with fluticasone furoate (an inhaled corticosteroid) is in development for asthma treatment. This secondary analysis aimed to develop a population pharmacokinetic model characterizing UMEC in adults with asthma, and evaluated the impact of covariates on pharmacokinetic parameters. METHODS: Plasma concentration data from study NCT01641692 (assessing once-daily UMEC 15.6, 31.25, 62.5, 125, and 250 mcg, twice daily UMEC 15.6 and 31.25 mcg, and placebo) were analyzed using non-linear mixed-effect modeling in NONMEM®. Full likelihood, including observed data and data below the quantification limit (treated as censored), was maximized. Study endpoints were population pharmacokinetics (including apparent inhaled clearance [CL/F] and apparent distribution volume in the central compartment [V c/F]) and derived pharmacokinetic parameters (area under the concentration-time curve [AUC] and maximum concentration [C max] at steady-state). RESULTS: In total, 128 patients provided 3757 data points. The pharmacokinetics of UMEC were best described using a two-compartment model with intravenous bolus input, due to fast absorption following inhalation. CL/F was 257 L/h and V c/F was 804 L. Creatinine clearance was a significant covariate for CL/F, as were age and body weight for V c/F. AUC and C max increased with increasing UMEC dose (once-daily 15.6-250 mcg: AUC0-24 median: 64.7-863 pg h/mL; C max median: 10.6-256 pg/mL). CONCLUSION: The final population pharmacokinetic model adequately described the data, demonstrating minimal creatinine clearance, age, and body weight effects on overall plasma UMEC pharmacokinetics and systemic exposure.
RCT Entities:
BACKGROUND:Umeclidinium (UMEC; a long-acting anti-muscarinic) in combination with fluticasone furoate (an inhaled corticosteroid) is in development for asthma treatment. This secondary analysis aimed to develop a population pharmacokinetic model characterizing UMEC in adults with asthma, and evaluated the impact of covariates on pharmacokinetic parameters. METHODS: Plasma concentration data from study NCT01641692 (assessing once-daily UMEC 15.6, 31.25, 62.5, 125, and 250 mcg, twice daily UMEC 15.6 and 31.25 mcg, and placebo) were analyzed using non-linear mixed-effect modeling in NONMEM®. Full likelihood, including observed data and data below the quantification limit (treated as censored), was maximized. Study endpoints were population pharmacokinetics (including apparent inhaled clearance [CL/F] and apparent distribution volume in the central compartment [V c/F]) and derived pharmacokinetic parameters (area under the concentration-time curve [AUC] and maximum concentration [C max] at steady-state). RESULTS: In total, 128 patients provided 3757 data points. The pharmacokinetics of UMEC were best described using a two-compartment model with intravenous bolus input, due to fast absorption following inhalation. CL/F was 257 L/h and V c/F was 804 L. Creatinine clearance was a significant covariate for CL/F, as were age and body weight for V c/F. AUC and C max increased with increasing UMEC dose (once-daily 15.6-250 mcg: AUC0-24 median: 64.7-863 pg h/mL; C max median: 10.6-256 pg/mL). CONCLUSION: The final population pharmacokinetic model adequately described the data, demonstrating minimal creatinine clearance, age, and body weight effects on overall plasma UMEC pharmacokinetics and systemic exposure.
Authors: Huib A M Kerstjens; Michael Engel; Ronald Dahl; Pierluigi Paggiaro; Ekkehard Beck; Mark Vandewalker; Ralf Sigmund; Wolfgang Seibold; Petra Moroni-Zentgraf; Eric D Bateman Journal: N Engl J Med Date: 2012-09-02 Impact factor: 91.245
Authors: Laurie A Lee; Shuying Yang; Edward Kerwin; Roopa Trivedi; Lisa D Edwards; Steven Pascoe Journal: Respir Med Date: 2014-10-02 Impact factor: 3.415
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