日本化学療法学会雑誌第57巻第S-2号
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- あいり しげまつ
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1 µ µ Key words µ µ µ I
2 Table1. Subjectprofilesin(A)singleand(B)multiple-dosestudies (A)Single-dosestudy Age (yr) Height (cm) Bodyweight (kg) BMI (kg/m ) Ccr(Cockcroft) (ml/min) Ethnicity dose(mg) n 5 5.1±., ±5.1,37 Japanese 75.±5.5,3 1, 5.±3.,3 placebo 1.±5. 1,37 17.±5. 16.± ± ± ± , , , ,1. 15., ± , ± , ± ,7. 1.6± ,.7 6.5± ,75.7.6± ,.7 6.± ,1. 3.±..1 1.,. 61.6± ,75.5.± ,.5 1.6± ± ± ±.5 11.± ,131,1 16,13 16,13 17,15 Caucasian 5 placebo 3 3.3± ± ,3, ± ± , ,1. 77.± ± ,. 6.,..±.3.±1....,.., ± ± ,1,11 (B)Multiple-dosestudy dose(mg) 5 7days nonelderly 5 7days nonelderly placebo 5 7days elderly 5 7days elderly placebo n 3 3 Age (yr) 3.±.5 3,7.7±3. 1,7 7.± ,73 7.3± ,7 Height (cm) 16.5± , ± , ± , ± ,17.3 Bodyweight (kg) 6.6± , ± ,71. 6.± , ± ,.6 BMI (kg/m ) 1.± ,.6.±3.. 1.,.3.± ,7. 5.6±. 6.5.,7. Ccr(Cockcroft) (ml/min) 11.± ,13.±15.,11.1± ,15 1.± ,15
3 (A)Single-dosestudy Hospitalization Dose Subjectbackground Investigator sexamination Height Bodyweight BMI Temperature,bloodpressure,pulserate 1-leadelectrocardiogram Clinicallaboratorytest Immunologicaltest Pharmacokinetic Monitoring Drugtest(urine) Table. Studyscheduleinthe(A)singleand(B)multiple-dosestudies Hematology,blood biochemistry,urinalysis Ccr Plasma 1) Saliva ),3) Urine ) Screening Day- <_ Folow-up 1) Bloodsamplescolected:immediatelybefore(timezero),.5,.5,1,1.5,,3,,,1,,36,,6,and 7h ) Salivarysamplescolected:immediatelybefore(timezero),1,,3,,,1,andh 3) Salivarysampleswerecolectedfrom subjectsadministeredlvfx5mg. ) Urinarysamplescolected:-,,,, 1,1,,and 7h (B)Multiple-dosestudy Hospitalization Dose Subjectbackground Investigator sexamination Height Bodyweight BMI Temperature,bloodpressure,pulserate 1-leadElectrocardiogram Clinicallaboratorytest Immunologicaltest Pharmacokinetic Monitoring Intestinalflora 3) Drugtest(urine) Hematology,blood biochemistry,urinalysis Ccr Plasma 1) Screening Day- <_ Folow-up 1 Urine ) ) ) 1) Bloodsamplescolected:day1;immediatelybefore(timezero),.5,.5,1,1.5,,3,,,and1h day 6;immediatelybefore(timezero)and1.5h day7;immediatelybefore(timezero),.5,.5,1,1.5,,3,,,and1h day;and36h day;and6h day1;7h ) Urinarysamplescolected:day-1;- h days1and7;,,, 1,and1 h 3) OnlynonelderlyJapanese.Fecessamplingwasdoneoncewithineachinterval. ) Asubjecthavingnobowelmovementwashospitalizedinthreedaysatmaximum.
4 5 mg (n ) 5 mg (n ) Plasma concentration ( g/ml) mg (n ) 1, mg (n ) Time (h) Fig.1. LVFX plasma concentration aftersingle-dose oraladministration to Japanese subjects (). Table3. LVFXpharmacokineticparametersinsingle-dosestudy Dose (mg) n Cmax (μ g/ml) tmax (h) AUC 7h (μ g h/ml) AUC inf (μ g h/ml) t1/ (h) CLt/F (L/h) Vdz/F (L) CLr (L/h) 5 Japanese mean SD Japanese Caucasian mean SD mean SD Japanese mean SD , Japanese mean SD
5 (A) 15 Y.13X 1.1 Cmax ( g/ml) Dose (mg) 75 1, (B) 15 1 Y.3X 1.17 AUC 7 h ( g h/ml) Dose (mg) 75 1, Fig.. TherelationshipbetweenLVFXpharmacokineticparametersversusdoseafter single-doseoraladministrationtojapanesesubjects(x=dose,y=parameter). (A)Cmax,(B)AUC 7h α β α β β
6 (A) 1 Cumulative urinary excretion ( of dose) 6 5 mg (n ) 5 mg (n ) 75 mg (n ) 1, mg (n ) Time (h) (B) Urinary concentrationg/ml 1,6 1, 1, 1, 6 5 mg (n ) 5 mg (n ) 75 mg (n ) 1, mg (n ) Time (h) Fig.3. (A)CumulativeLVFX urinaryexcretionand(b)lvfx urinaryconcentrationafter single-doseoraladministrationtojapanesesubjects(). II µ µ β β β
7 1 1 Saliva (n ) Plasma (n ) Concentration ( g/ml) Time (h) Fig.. LVFXsalivaryandplasmaconcentrationafter5mgsingle-doseoraladministration tojapanesesubjects(). Plasma concentration ( g/ml) 1 6 Nonelderly (n ) Elderly (n ) Time (h) Fig.5. LVFXplasmaconcentrationin5mgmultiple-dosestudy(). β µ µ µ
8 (A)Day1 Group n Table. LVFXpharmacokineticparametersinmultiple-dosestudy Cmax (μ g/ml) Ch (μ g/ml) tmax (h) AUC h (μ g h/ml) LVFX5mg mean nonelderly SD LVFX5mg mean elderly SD (B)Day7 Group n Cmax (μ g/ml) Ch (μ g/ml) tmax (h) AUC h (μ g h/ml) t1/ (h) CLt/F (L/h) Vdz/F (L) CLr (L/h) LVFX5mg mean nonelderly SD LVFX5mg mean elderly SD µ µ µ µ µ µ µ µ µ µ µ µ Clostridium difficile C. difficile III µ µ
9 1 1 Aerobes (log CFU/g) Mean number of aerobic bacteriae (n ): Enterobacteriaceae, NFGNR, Staphylococcus, Streptococcus, Enterococcus, Bacillus, Corynebacterium, Yeast, Total aerobes 1 1 Anaerobes (log CFU/g) Mean number of anaerobic bacteriae (n ): Bacteroidaceae, Fusobacterium, Lecithinase ( ) Clostridium, Lecithinase ( ) Clostridium, Veillonella, Megasphaera, Bifidobacterium, Eubacterium, Peptococcaceae, Lactobacillus, Total anaerobes Fig.6. ImpactsofLVFXadministrationonintestinalflorainnonelderlyJapaneseinmultiple-dose study. Abscissa 1:daysbeforedose-day1 :day1 day3 3:day day6 :day7 day 5:day1 6:day
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