Systemic exposure to inhaled beclometasone/formoterol DPI is age and body size dependent
Autor: | Francesco Sergio, Daniela Acerbi, Li Juel Mortensen, Dave Singh, Nasim Samandari, Maja Deleuran, Erik Nilsson, Bo L. Chawes, Eskil Kreiner-Møller, Mirco Govoni, Gianluigi Poli, Anna Dossing, Nanna L. Skytt, Annalisa Piccinno, Giorgia Ciurlia, Porntiva Poorisrisak, Anne Marie Bisgaard, Hans Bisgaard, Nadja Hawwa Vissing |
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Rok vydání: | 2014 |
Předmět: |
Adult
Pulmonary and Respiratory Medicine Adolescent Fixed-dose combination Cmax Pharmacology Adolescents Young Adult Pharmacokinetics Forced Expiratory Volume Formoterol Fumarate Administration Inhalation Body Size Humans Medicine Beclometasone-dipropionate Anti-Asthmatic Agents Metered Dose Inhalers Formoterol Child Children Aged Asthma Body surface area Analysis of Variance Cross-Over Studies business.industry Age Factors Beclomethasone Beclometasone dipropionate Middle Aged respiratory system medicine.disease Dry-powder inhaler DPI Ethanolamines business Half-Life medicine.drug |
Zdroj: | Respiratory Medicine. 108:1108-1116 |
ISSN: | 0954-6111 |
DOI: | 10.1016/j.rmed.2014.05.007 |
Popis: | Summary Aim Prescription of inhaled corticosteroids to children with asthma is recommended at half the nominal dose of adults in order to reduce the risk of systemic side effects. However, there is a lack of pharmacokinetic trials supporting such dose reduction regimens. Therefore, we aimed to compare the systemic exposure to the active ingredients of a fixed dose combination of beclometasone-dipropionate (BDP) and formoterol after dry powder inhaler (DPI) administration in children, adolescents and adults. Methods The pharmacokinetic profiles of formoterol and beclometasone-17-monopropionate (B17MP; active metabolite of BDP) were evaluated over 8 h from two independent studies comprising children (6–11yrs, n = 27), adolescents (12–17 yrs, n = 28) and adults (≥18 yrs, n = 30) receiving a single, fixed dose of BDP/formoterol (children: 200 μg/24 μg, adolescents and adults: 400 μg/24 μg) via DPI. Results The systemic exposure (AUC) for children versus adults was almost doubled for formoterol and similar for B17MP despite the halved BDP dose administered in children. In adolescents the AUC for formoterol and B17MP were approximately one third higher than in adults for both compounds. Upon normalization for the BDP/formoterol dose in the three populations the AUC and peak concentration ( C max ) correlated inversely with age and body surface area of the patients ( r ≤ −0.53; p Conclusion The systemic exposure to the active ingredients of BDP/formoterol administered as DPI correlates inversely with age and body size suggesting that dry powder dosage regimens should be adjusted for age and body size to avoid high systemic drug levels in children. |
Databáze: | OpenAIRE |
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