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An Open-Label Study of the Impact of Hepatic Impairment on the Pharmacokinetics and Safety of Single Oral and Intravenous Doses of Omadacycline.
Antimicrobial Agents and Chemotherapy ( IF 4.9 ) Pub Date : 2020-10-20 , DOI: 10.1128/aac.01650-20
Steven J Kovacs 1 , Lillian Ting 1 , Jens Praestgaard 1 , Gangadhar Sunkara 1 , Haiying Sun 1 , Daniel S Stein 1 , S Ken Tanaka 2 , Stephen Villano 3
Affiliation  

Omadacycline is a once-daily oral or intravenous (i.v.) aminomethylcycline antibiotic approved in the United States for the treatment of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSI) in adults. Omadacycline pharmacokinetics were characterized in 18 patients with hepatic impairment and 12 matched healthy subjects. Patients with hepatic impairment received i.v. omadacycline at 100 mg (mild hepatic impairment) or 50 mg (moderate and severe hepatic impairment) and oral omadacycline at 300 mg (mild hepatic impairment) or 150 mg (moderate hepatic impairment); oral omadacycline was not evaluated in those with severe hepatic impairment. Safety monitoring included the collection of adverse events (AEs), performance of laboratory tests, determination of vital signs, and performance of electrocardiograms. Omadacycline exposures were similar in patients with hepatic impairment and healthy subjects following i.v. or oral administration, with the geometric mean ratios for the area under the concentration-time curve and the maximum drug concentration ranging from 0.79 to 1.42. Omadacycline was safe and well tolerated. Overall, 13/30 (43.3%) participants experienced an AE; those occurring in more than 1 participant included headache (13.3%), nausea (6.7%), infusion-site pain (6.7%), contusion (6.7%), and dizziness (6.7%), with no differences based on the degree of hepatic impairment or the route of administration. Asymptomatic increases in heart rate were observed; none was considered an AE. These findings suggest that no omadacycline dose adjustment is warranted in patients with hepatic impairment.

中文翻译:

肝功能不全对Omadacycline单次口服和静脉给药的药代动力学和安全性影响的开放标签研究。

Omadacycline是美国批准的每日一次口服或静脉内(iv)氨基甲基环素抗生素,用于治疗成人社区获得性细菌性肺炎(CABP)和急性细菌性皮肤和皮肤结构感染(ABSSSI)。Omadacycline的药代动力学在18例肝功能不全患者和12例匹配的健康受试者中进行了表征。肝功能不全的患者接受100 mg(轻度肝功能不全)或50 mg(中度和重度肝功能不全)iv马达环素和300 mg(轻度肝功能不全)或150 mg(中度肝功能不全)口服阿马达环素; 严重肝功能不全者未评估口服奥马环素。安全监控包括不良事件(AE)的收集,实验室测试的执行,生命体征的确定,和心电图的表现。静脉内或口服后,肝功能不全患者和健康受试者的Omadacycline暴露量相似,其浓度-时间曲线下面积的几何平均比率和最大药物浓度范围为0.79至1.42。Omadacycline安全且耐受良好。总体而言,有13/30(43.3%)的参与者经历了AE;超过1名参与者发生的症状包括头痛(13.3%),恶心(6.7%),输液部位疼痛(6.7%),挫伤(6.7%)和头晕(6.7%),根据程度的不同无差异肝功能不全或给药途径。观察到无症状心率增加;没有人被认为是AE。这些发现表明,肝功能不全的患者无需调整奥马环素剂量。静脉内或口服后,肝功能不全患者和健康受试者的Omadacycline暴露量相似,其浓度-时间曲线下面积的几何平均比率和最大药物浓度范围为0.79至1.42。Omadacycline安全且耐受良好。总体而言,有13/30(43.3%)的参与者经历了AE;超过1名参与者发生的症状包括头痛(13.3%),恶心(6.7%),输液部位疼痛(6.7%),挫伤(6.7%)和头晕(6.7%),根据程度的不同无差异肝功能不全或给药途径。观察到无症状心率增加;没有人被认为是AE。这些发现表明,肝功能不全的患者无需调整奥马环素剂量。静脉内或口服后,肝功能不全患者和健康受试者的Omadacycline暴露量相似,其浓度-时间曲线下面积的几何平均比率和最大药物浓度范围为0.79至1.42。Omadacycline安全且耐受良好。总体而言,有13/30(43.3%)的参与者经历了AE;超过1名参与者发生的症状包括头痛(13.3%),恶心(6.7%),输液部位疼痛(6.7%),挫伤(6.7%)和头晕(6.7%),根据程度的不同无差异肝功能不全或给药途径。观察到无症状心率增加;没有人被认为是AE。这些发现表明,肝功能不全的患者无需调整奥马环素剂量。
更新日期:2020-10-20
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