Population pharmacokinetics and pharmacodynamics of ticagrelor and AR-C124910XX in Chinese healthy male subjects.

Background: Ticagrelor, the first reversible P2Y12 receptor antagonist, exhibits faster onset and offset of antiplatelet effects and more consistent platelet inhibition than clopidogrel in both healthy subjects and patients with stable coronary artery disease.Objective: The objectives of this study...

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Publicado en:European Journal of Clinical Pharmacology Vol. 74; no. 6; pp. 745 - 755
Autores principales: Liu, Shuaibing, Xue, Ling, Shi, Xiangfen, Sun, Zhiyong, Zhu, Zhenfeng, Zhang, Xiaojian, Tian, Xin
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2018
      vid: 74
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-018-2427-3
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        atl: Population pharmacokinetics and pharmacodynamics of ticagrelor and AR-C124910XX in Chinese healthy male subjects.
      aug:
        au:
          Liu, Shuaibing
          Xue, Ling
          Shi, Xiangfen
          Sun, Zhiyong
          Zhu, Zhenfeng
          Zhang, Xiaojian
          Tian, Xin
        affil: Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
      sug:
        subj:
          Platelet Aggregation Inhibitors Pharmacodynamics
          Platelet Aggregation Inhibitors Pharmacokinetics
          Models, Theoretical
          Platelet Aggregation Drug Effects
          Platelet Aggregation Inhibitors Metabolism
          Human
          China
          Chinese Persons
          Male
          Platelet Aggregation Inhibitors Administration and Dosage
          Polymorphism, Genetic
          Biotransformation
          Enzymes
          Polymerase Chain Reaction
          Genotype
          Sequence Analysis
          Platelet Aggregation Inhibitors Blood
          Absorption
          Simulations
          Dose-Response Relationship, Drug
          Male
      ab: Background: Ticagrelor, the first reversible P2Y12 receptor antagonist, exhibits faster onset and offset of antiplatelet effects and more consistent platelet inhibition than clopidogrel in both healthy subjects and patients with stable coronary artery disease.Objective: The objectives of this study were to establish a population pharmacokinetics (PK) and pharmacodynamics (PD) model of ticagrelor and to provide a theoretical basis for the optimization of ticagrelor treatment in clinic.Methods: A single oral dose of 180 mg ticagrelor was administered to 14 healthy male subjects in a randomized study. Common single-nucleotide polymorphisms (SNPs) in biotransformation enzymes CYP3A4 and CYP3A5 (CYP3A4*1G and CYP3A5*3) were genotyped by PCR-direct sequencing. Blood samples were collected to measure plasma concentrations of ticagrelor and its active metabolite AR-C124910XX and maximal platelet inhibition. Various models were evaluated to characterize the pharmacokinetics of ticagrelor and AR-C124910XX as well as their PK-PD relationship. Covariates that may potentially affect PK or PD of ticagrelor and AR-C124910XX were included and assessed. Simulation for dosage regimen was performed based on the final PK-PD model.Results: Ticagrelor and AR-C124910XX PK were best described by a two-compartment model with first-order transit absorption model. CYP3A4*1G increased clearance for AR-C124910XX, but had no significant effect on ticagrelor clearance. The relationship between concentration and platelet response of ticagrelor was best described by a turnover model. Simulation results indicated that a lower dosage regimen of 30 mg maintenance dose (MD) could produce an anticipated anti-platelet response in comparison to the routine clinical dosage regimen (180 mg loading dose (LD), 90 mg MD).Conclusion: Our study developed a population PK-PD model for ticagrelor and further simulation for dosage regimen was performed based on the final model. Compared to the current recommended dosage regimen (180 mg LD, 90 mg MD), our simulation result of a relatively lower dose (30 mg MD) could also obtain an acceptable anti-platelet response, which may provide a reference for further dosage regimen design in Chinese population.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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