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Shibata RY, Kubota R, Uenaka K, Kaibara A, Wajima T. Population pharmacokinetics of duloxetine in Japanese pediatric patients with major depressive disorder. Drug Metab Pharmacokinet 2023; 51:100496. [PMID: 37244205 DOI: 10.1016/j.dmpk.2023.100496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/16/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
The objectives of this analysis were to characterize the pharmacokinetics of duloxetine in Japanese pediatric patients aged 9-17 years with major depressive disorder (MDD) and to explore potential intrinsic factors affecting its pharmacokinetics. A population pharmacokinetic (PK) model was developed with plasma steady-state duloxetine concentrations from Japanese pediatric patients with MDD in an open-label long-term extension trial in Japan (ClinicalTrials.gov Identifier: NCT03395353). Duloxetine pharmacokinetics in Japanese pediatric patients was well described by a one-compartment model with first-order absorption. The population mean estimates of CL/F and V/F of duloxetine were 81.4 L/h and 1170 L, respectively. Patient intrinsic factors were assessed for their potential influence on duloxetine apparent clearance (CL/F). Only sex was identified as a statistically significant covariate of duloxetine CL/F. Duloxetine pharmacokinetic parameters and model-predicted duloxetine concentrations at steady state in the Japanese pediatric population were compared with those in Japanese adults. The mean duloxetine CL/F in pediatrics is slightly higher than adults, it is, however, expected that comparable steady-state duloxetine exposure in pediatric patients can be achieved with the approved dose regimen for adults. The population PK model provides useful information to understand the pharmacokinetic characteristics of duloxetine for Japanese pediatric patients with MDD. CLINICALTRIALS.GOV IDENTIFIER: NCT03395353.
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Nakano M, Nakamura T, Takita Y, Uenaka K, Ando T, Senda M, Joshi AD, Lu M, Breault C, Pontecorvo MJ. Radiation dosimetry and pharmacokinetics of florbetapir ( 18F) in Japanese subjects. Ann Nucl Med 2019; 33:639-645. [PMID: 31140155 DOI: 10.1007/s12149-019-01366-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Masako Nakano
- Eli Lilly Japan K.K., 5-1-28 Isogamidori, Chuo-Ku, Kobe, 651-0086, Japan.
| | - Tomomi Nakamura
- Eli Lilly Japan K.K., 5-1-28 Isogamidori, Chuo-Ku, Kobe, 651-0086, Japan
| | - Yasushi Takita
- Eli Lilly Japan K.K., 5-1-28 Isogamidori, Chuo-Ku, Kobe, 651-0086, Japan
| | - Kazunori Uenaka
- Eli Lilly Japan K.K., 5-1-28 Isogamidori, Chuo-Ku, Kobe, 651-0086, Japan
| | - Tomoaki Ando
- Eli Lilly Japan K.K., 5-1-28 Isogamidori, Chuo-Ku, Kobe, 651-0086, Japan
| | - Michio Senda
- Division of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe, Japan
| | | | - Ming Lu
- Avid Radiopharmaceuticals, Philadelphia, PA, USA
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Iida S, Ogiya D, Abe Y, Taniwaki M, Asou H, Maeda K, Uenaka K, Nagaoka S, Ishiki T, Conti I, Tobinai K. Dose-escalation study of tabalumab with bortezomib and dexamethasone in Japanese patients with multiple myeloma. Cancer Sci 2016; 107:1281-9. [PMID: 27350068 PMCID: PMC5021044 DOI: 10.1111/cas.13000] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/17/2016] [Accepted: 06/26/2016] [Indexed: 01/03/2023] Open
Abstract
B‐cell activating factor (BAFF) promotes the survival and adhesion of multiple myeloma (MM) cells. Tabalumab (LY2127399) is an anti‐BAFF monoclonal antibody. This phase 1, multicenter, open‐label, nonrandomized, dose‐escalation study evaluated the safety, tolerability, pharmacokinetics, pharmacodynamics and efficacy of tabalumab in combination with bortezomib and dexamethasone in Japanese patients with relapsed or refractory MM (RRMM). Sixteen patients received intravenous i.v. tabalumab 100 mg (Cohort 1, n = 4) or i.v. tabalumab 300 mg (Cohort 2, n = 12) in combination with oral dexamethasone 20 mg/day and i.v. or s.c. bortezomib 1.3 mg/m2. All patients had treatment‐emergent adverse events (TEAE) possibly related to study treatment; the most common TEAE were thrombocytopenia (81.3%), lymphopenia (43.8%) and increased alanine aminotransferase (43.8%). Two (20.0%) dose‐limiting toxicities were observed, both in Cohort 2 (tabalumab 300 mg), which was below the predefined cutoff for tolerability (<33%). The pharmacokinetics of tabalumab were similar when bortezomib was coadministered i.v. versus s.c. The overall response rate was 56.3%, suggesting that the combined treatment was effective. In conclusion, combined treatment with these three agents was well tolerated in this population of Japanese patients with RRMM. The study was registered at www.clinicaltrials.gov (NCT01556438).
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Affiliation(s)
- Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan.
| | - Daisuke Ogiya
- Division of Hematology and Oncology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yasunobu Abe
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masafumi Taniwaki
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroya Asou
- Medical Science, Eli Lilly Japan K.K., Kobe, Japan
| | | | | | - Soshi Nagaoka
- Statistical Science, Eli Lilly Japan K.K., Kobe, Japan
| | | | - Ilaria Conti
- Global Medical, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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Chung HC, Satoh T, Oh DY, Park SH, Kadowaki S, Wacheck V, Yamamura A, Uenaka K, Wang XA, Wijayawardana SR, Doi T. Abstract C121: A non-randomized, open-label, single-arm, phase 2 study of LY2875358 in Asian patients with MET diagnostic positive, advanced gastric cancer. Mol Cancer Ther 2015. [DOI: 10.1158/1535-7163.targ-15-c121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: MET is expressed in gastric cancer and associated with poor clinical outcome. LY2875358 (LY) is a humanized immunoglobin G4 (IgG4) monoclonal bivalent antibody blocking ligand-dependent and independent MET signaling. In preclinical studies, LY showed single agent anti-tumor activity for MET amplified gastric cancer in xenograft models. Based on these results, a non-randomized, multicenter, single-arm, open-label, Phase 2 study was conducted to evaluate the antitumor activity of LY in patients (pts) with MET diagnostic positive (+), advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma.
Methods: Pts with MET diagnostic (+), advanced gastric or GEJ adenocarcinoma, who had received 2 prior chemotherapies, were administered LY 2000 mg as flat dose intravenously every 2 weeks (Q2W) on a 28 day cycle. MET diagnostic (+) tumor status was determined by immunohistochemistry (IHC). The primary objective was to evaluate the activity of LY in terms of progression-free survival (PFS) rate at 8 weeks (+ 3 days). Secondary objectives were to assess other efficacy variables (eg overall response rate, disease control rate [DCR], PFS, overall survival [OS]), toxicity and safety profile of LY, and pharmacokinetics (PK). The exploratory objectives included evaluation of pharmacodynamics, pharmacogenomics, and exploratory biomarkers.
Results: Tumor samples of 65 pts were screened for MET expression by IHC and 15 pts (23.1%) with MET diagnostic (+) were enrolled in this study. Fifteen pts (5 female, 10 male) from Asia (Japan 8, Korea 7) with a median age of 63 years (range 39-74) were enrolled. PFS rate at 8 weeks was 47% (70% Confidence Interval [CI]: 33%, 59%). There was no partial response according to RECIST, while shrinkage of tumor size was observed in 3 out of 15 pts. DCR was 40.0%, with stable disease shown in 6 out of 15 pts. Median PFS was 8.3 weeks (95% CI: 4.1, 12.1) with stable disease for up to a maximum of 37.1 weeks. Median OS was 17.1 weeks (95% CI: 6.3, Not Available). A total of 12 pts (80%) experienced at least 1 LY-related treatment-emergent adverse event (TEAE). Common LY-related TEAE (all grades) included constipation and hypoalbuminemia (3 pts [20%] each). LY-related TEAEs with Grade ≥ 3 were hyponatremia and hyperuricemia (2 events in 1 patient), and hyperkalemia (1 patient). Serious adverse events were reported in 6 patients, none of which was related to LY. There was no TEAE leading to death or study treatment discontinuation. PK profiles were similar to those observed in previous studies of LY monotherapy, which were conducted in the United States, and the majority of patients were Caucasian. Exploratory biomarker analysis (IHC data) will be presented at the venue.
Conclusion: LY 2000 mg Q2W showed a well-tolerated safety profile with a limited single agent activity in heavily pretreated patients with MET diagnostic (+), advanced gastric or GEJ adenocarcinoma.
Citation Format: Hyun Cheol Chung, Taroh Satoh, Do-Youn Oh, Se Hoon Park, Shigenori Kadowaki, Volker Wacheck, Ayuko Yamamura, Kazunori Uenaka, Xuejing Aimee Wang, Sameera R. Wijayawardana, Toshihiko Doi. A non-randomized, open-label, single-arm, phase 2 study of LY2875358 in Asian patients with MET diagnostic positive, advanced gastric cancer. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr C121.
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Affiliation(s)
| | | | - Do-Youn Oh
- 3Seoul National University Hospital, Seoul, Korea, Republic of
| | - Se Hoon Park
- 4Samsung Medical Center, Seoul, Korea, Republic of
| | | | | | | | | | | | | | - Toshihiko Doi
- 8National Cancer Center Hospital East, Kashiwa, Japan
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Nokihara H, Yamamoto N, Yamada Y, Yamada K, Goto Y, Tanioka M, Nambu Y, Uenaka K, Sekiguchi R, Tamura T. Abstract B48: A phase 1 study of an antisense oligonucleotide against survivin (LY2181308) in Japanese patients with solid tumors. Clin Trials 2014. [DOI: 10.1158/1535-7163.targ-09-b48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Imai S, Uenaka K, Matsusue Y. Idiopathic necrosis of the capitate treated by vascularized bone graft based on the 2, 3 intercompartmental supraretinacular artery. J Hand Surg Eur Vol 2014. [PMID: 23204133 DOI: 10.1177/1753193412468396] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S Imai
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Shiga-ken, Japan
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Yamamoto N, Nokihara H, Yamada Y, Uenaka K, Sekiguchi R, Makiuchi T, Slapak CA, Benhadji KA, Tamura T. Phase I study of oral gemcitabine prodrug (LY2334737) in Japanese patients with advanced solid tumors. Cancer Chemother Pharmacol 2013; 71:1645-55. [PMID: 23616084 DOI: 10.1007/s00280-013-2165-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 04/12/2013] [Indexed: 01/17/2023]
Abstract
PURPOSE LY2334737 is an oral gemcitabine prodrug. This Phase I study assessed the safety and tolerability of LY2334737 in Japanese patients with solid tumors and evaluated pharmacokinetics (PK), pharmacodynamics, and antitumor activity. METHODS Patients with advanced/metastatic solid tumors received escalating doses of LY2334737 once daily for 14 days, followed by a 7-day drug-free period. Cycles were repeated until discontinuation criteria were met. RESULTS Of 13 patients treated, 3 received 20 mg/day, 6 received 30 mg/day, 4 received 40 mg/day. On the 40 mg dose, 3 patients experienced dose-limiting toxicities (DLTs): hepatic toxicities (e.g., Grade [G]3/4 transaminase and G1-3 bilirubin elevation) and G4 thrombocytopenia; all 3 showed features of disseminated intravascular coagulation. One additional DLT occurred on the 30 mg dose (G3 transaminase elevation). Exploratory pharmacogenetic analyses identified a genetic variation in the CES2 gene potentially associated with these DLTs. PK data showed no clear relationship between the AUC of gemcitabine and its incorporation into leukocyte DNA; 2 of the 3 DLT patients had high incorporation. Two patients (30 mg/day) achieved stable disease with progression-free survival lasting 135 and 155 days. CONCLUSIONS LY2334737 was tolerated by Japanese patients up to 30 mg/day. The toxicities observed at the 40 mg dose may require the development of alternative dosing schedules.
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Affiliation(s)
- Noboru Yamamoto
- Division of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Kothare PA, Linnebjerg H, Isaka Y, Uenaka K, Yamamura A, Yeo KP, de la Peña A, Teng CH, Mace K, Fineman M, Shigeta H, Sakata Y, Irie S. Pharmacokinetics, Pharmacodynamics, Tolerability, and Safety of Exenatide in Japanese Patients With Type 2 Diabetes Mellitus. J Clin Pharmacol 2013; 48:1389-99. [DOI: 10.1177/0091270008323750] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tsujimoto M, Uenaka K, Iwata A, Higashiuchi Y, Sowa H. Effects of teriparatide in Japanese and non-Japanese populations: bridging findings on pharmacokinetics and efficacy. J Bone Miner Metab 2012; 30:326-37. [PMID: 21938381 DOI: 10.1007/s00774-011-0314-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 08/16/2011] [Indexed: 11/28/2022]
Abstract
Teriparatide is an anabolic therapy for osteoporosis approved in the United States since 2002 and European Union since 2003; however, approval in Japan lagged significantly. This report describes analyses based on International Conference on Harmonisation (ICH) E-5 guidelines that support bridging between Japanese studies and the large Fracture Prevention Trial (FPT). We analyzed data from single teriparatide doses in healthy Japanese and Caucasian postmenopausal women (J-PK) and from studies of 6 months [Phase 2, dose ranging (J-Ph2)] and 12 months [Phase 3, efficacy and safety (J-Ph3)] of randomized, placebo-controlled, once-daily treatment in Japanese subjects with osteoporosis. In J-PK, apparent teriparatide area-under-the-curve (AUC) and peak concentration (C (max)) were up to 40% higher in Japanese versus Caucasian women; however, body weight-adjusted values were comparable between populations; these findings were supported by population pharmacokinetic analyses. Between the FPT and Japanese studies, baseline demographic characteristics were similar but bone mineral density (BMD) at lumbar spine (L1-L4) and body weight were lower for Japanese subjects. With teriparatide 20 μg/day, significant increases in BMD were observed compared to placebo at 12 months in both the FPT and J-Ph3 study, and percent change and actual change in BMD were comparable between studies. Dose response at 6 months was also comparable across populations. No novel safety signals were identified in Japanese subjects. These analyses show that teriparatide clinical data met ICH E-5 criteria for bridging. Findings from foreign trials such as the FPT can thus be extrapolated to Japanese subjects treated with teriparatide 20 μg/day.
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Affiliation(s)
- Mika Tsujimoto
- Lilly Research Laboratories-Development Center of Excellence-Asia Pacific, Eli Lilly Japan K.K., Sannomiya Plaza Bldg., 7-1-5 Isogamidori, Chuo-ku, Kobe, 651-0086, Japan.
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Tanioka M, Nokihara H, Yamamoto N, Yamada Y, Yamada K, Goto Y, Fujimoto T, Sekiguchi R, Uenaka K, Callies S, Tamura T. Phase I study of LY2181308, an antisense oligonucleotide against survivin, in patients with advanced solid tumors. Cancer Chemother Pharmacol 2010; 68:505-11. [PMID: 21079959 DOI: 10.1007/s00280-010-1506-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 10/26/2010] [Indexed: 12/20/2022]
Abstract
PURPOSE LY2181308 is an antisense oligonucleotide that complementarily binds to survivin mRNA and inhibits its expression in tumor tissue. This phase I dose escalation study evaluated the tolerability, pharmacokinetics, and anticancer activity of LY2181308 in Japanese. METHODS Patients with solid tumors refractory to standard therapy received LY2181308 (400, 600, or 750 mg) as a 3-h intravenous infusion for 3 consecutive days and thereafter once a week. RESULTS LY2181308 was administered to 14 patients, aged 44-73 (median 60) years. Flu-like syndrome, prolonged prothrombin time-international normalized ratio (PT-INR), thrombocytopenia, and fatigue were common reversible grade 1/2 toxicities. The dose-limiting toxicity was reversible grade 3 elevation of ALT/AST/γ-GTP in 1 patient treated at the 750-mg dose. Pharmacokinetic analysis showed a long terminal half-life of 21 days and an extensive tissue distribution of LY2181308. In 12 evaluable patients, one patient had stable disease, while the remaining 11 patients had progressive disease. CONCLUSIONS LY2181308 monotherapy is well tolerated up to 750 mg with a manageable toxicity, the pharmacokinetic profile warrants further evaluation of LY2181308 in combination with cytotoxic agents or radiotherapy.
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Affiliation(s)
- M Tanioka
- Division of Internal Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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Kumamoto M, Nakano M, Uenaka K, Lowe S, Nishiuma S, Nakamichi N, Dean R, Siemers E, Mohs R. P4‐379: Safety, tolerability, pharmacokinetics and pharmacodynamics of multiple‐dose administration of a gamma‐secretase inhibitor in Japanese subjects. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.2449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Stephen Lowe
- Lilly-NUS Centre for Clinical PharmacologySingaporeSingapore
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Kawate N, Itami T, Choushi T, Saitoh T, Wada T, Matsuoka K, Uenaka K, Tanaka N, Yamanaka A, Sakase M, Tamada H, Inaba T, Sawada T. Improved conception in timed-artificial insemination using a progesterone-releasing intravaginal device and Ovsynch protocol in postpartum suckled Japanese Black beef cows. Theriogenology 2004; 61:399-406. [PMID: 14662139 DOI: 10.1016/s0093-691x(03)00239-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The primary objective was to determine the effect of supplemental progesterone, administered via an intravaginal device (CIDR), on conception rates to timed-artificial insemination (timed-AI) in postpartum suckled Japanese Black beef cows treated with the Ovsynch protocol. A secondary objective was to compare the effects of treatments on plasma concentrations of progesterone and estradiol. Cows in the control group (Ovsynch, n=38) received a standard Ovsynch protocol (100 microg GnRH analogue on Day 0, 500 microg PGF2alpha analogue on Day 7, and 100 microg GnRH analogue on Day 9), with AI on Day 10, approximately 20 h after the second GnRH treatment. Cows in the treatment group (Ovsynch+CIDR; n=40) received a standard Ovsynch protocol plus a CIDR for 7 days (starting on Day 0). Plasma progesterone concentrations were determined on Days 0, 1, 7, 9, 10, and 17 and plasma estradiol-17beta concentrations were determined on Days 7, 9, 10, and 17. The odds ratio for likelihood of conception was 3.29 times greater (P=0.02) in the Ovsynch+CIDR group compared to Ovsynch group. The conception rate was greater (P=0.03) in the Ovsynch+CIDR group than in the Ovsynch group (72.5% versus 47.7%). Insertion of a CIDR device significantly increased plasma progesterone concentrations only on Days 1 and 7 (P<0.001 and P=0.05, respectively), but had no significant effect on plasma estradiol-17beta concentrations. Including a CIDR with the Ovsynch protocol significantly improved conception rates in postpartum suckled Japanese Black beef cows.
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Affiliation(s)
- N Kawate
- Laboratory of Theriogenology, Graduate School of Agriculture and Biological Sciences, Osaka Prefecture University, Sakai, Osaka 599-8531, Japan.
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Morimoto S, Mishima H, Tsujinaka T, Kawato N, Shono Y, Tsuji T, Tabuse K, Nakata I, Saito M, Uenaka K. [Combined determination of urine uracil levels and plasma 5-FU clearance for a simple order-made treatment with anticancer agents of FU derivative]. Gan To Kagaku Ryoho 2003; 30:89-94. [PMID: 12557710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Individual differences exist in the pharmacodynamics of fluorouracil-derived anticancer agents, with circadian variability even in the same patient probably due to individual differences in the distribution of dihydrophrimidine dehydrogenase (DPD), a decomposing enzyme. Though DPD activity is usually determined in the liver or blood, a more simplified estimation of DPD activity has been recently attempted using urine uracil levels. However, because urine uracil level has the drawback of being easily affected by food ingestion or kidney function, in this study it was determined simultaneously with the determination of plasma 5-FU clearance after sustained instillation of 250 mg 5-FU, in order to estimate DPD activity more accurately. A correlation was observed between urine uracil levels and 5-FU clearance. In cases showing a baseline urine uracil level below 25.1 mumol/g. Creatinine, the blood concentration decreased due to large 5-FU clearance, with a tendency for diminished efficacy of FU-derived anticancer agents. In cases showing a baseline urine uracil level above 99.9 mumol/g. Creatinine, on the other hand, adverse reactions due to FU anticancer agents tended to become more serious. Since urine uracil level can be determined easily, it could be the first choice in screening to detect abnormal metabolism of fluorouracil-derived anticancer agents under present circumstances. By combining determination of urine uracil level with 5-FU clearance, it seems possible to predict adverse effects and the effective rate of these agents more accurately. Under existing circumstances, where genetic analysis remains unavailable as a general practice, the combined determination of urine uracil levels and plasma 5-FU clearance may be beneficial in developing order-made treatments in cancer chemotherapy.
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Uenaka K, Koue T, Iwai T, Shibakawa M, Ueno K. Population pharmacokinetic analysis of mexiletine in adult arrhythmic patients in Japanese population. Biol Pharm Bull 1998; 21:844-6. [PMID: 9743254 DOI: 10.1248/bpb.21.844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We analyzed mexiletine in Japanese patients using population pharmacokinetics. 139 serum concentration data, which were collected for therapeutic drug monitoring from 121 patients, were used for this analysis. We also investigated influence of age and gender on pharmacokinetics, and age was found to be an influential factor on clearance. The final pharmacokinetic parameters are, CL/F=0.580-0.00369 x AGE (l/h/kg) and Vd/F=6.63 (l/kg). These results should be useful for adjusting the dosage to a patient's age for the prevention of an adverse reaction caused by overexposure.
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Affiliation(s)
- K Uenaka
- Otsuka Assay Laboratory, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
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Yamamoto N, Tamura T, Karato A, Uenaka K, Eguchi K, Shinkai T, Ohe Y, Oshita F, Arioka H, Nakashima H. CPT-11: population pharmacokinetic model and estimation of pharmacokinetics using the Bayesian method in patients with lung cancer. Jpn J Cancer Res 1994; 85:972-7. [PMID: 7961128 PMCID: PMC5919593 DOI: 10.1111/j.1349-7006.1994.tb02977.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In this study, we aimed to develop a population pharmacokinetic model for CPT-11 and to use the Bayesian method to estimate CPT-11 pharmacokinetic parameters in each of 43 patients who received combined therapy consisting of CPT-11 and etoposide. The group was divided into first and second data sets of 30 and 13 patients, respectively. We developed a population pharmacokinetic model of CPT-11 based on the first data set. The individual pharmacokinetic parameters [area under the concentration curve (AUC) and clearance (CL)] were subsequently estimated by using the Bayesian method on the second data set. Plasma CPT-11 concentrations were measured by high-performance liquid chromatography, and compartmental pharmacokinetic models were fitted by the Bayesian method. The population pharmacokinetic model was developed by using the nonlinear mixed effect model. We selected the volume of the central compartment (Vc), CL, and distribution rate constants (K12, K21) as population pharmacokinetic parameters. The population mean values (CV%) of Vc, CL, K12, and K21 were, respectively, 31.8 (15.7%) liter/m2, 14.1 (27.8%) liter/h/m2, 1.1 (8.4%)/h, and 0.41 (30.3%)/h. Residual intraindividual variability was 22.9%. The optimal sampling regime for estimation of the AUC and CL in using the Bayesian method was the two time points of 1 and 8 h post infusion. The mean predictive error, the mean absolute predictive error, and the root mean squared error were -3.3, 9.4, 3.2% (AUC) and 6.3, 10.0, 3.5% (CL), respectively. We concluded that the AUC and CL of CPT-11 could be estimated from plasma concentrations at two times by using the Bayesian method.
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Affiliation(s)
- N Yamamoto
- Department of Medical Oncology, National Cancer Center, Tokyo
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