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Antimicrobial Agents and Chemotherapy, April 1998, p. 903-906, Vol. 42, No. 4
C.H.U. Saint-Pierre, Brussels,
Belgium,1 and
Zeneca Pharmaceuticals,
Macclesfield, England2
Received 21 April 1997/Returned for modification 15 June
1997/Accepted 23 December 1997
D0870 is a triazole with a broad antifungal spectrum, and it has
been shown to have both in vitro and in vivo activities against wild-type and fluconazole-resistant strains of Candida
albicans. Twenty-two human immunodeficiency virus (HIV)-positive
male subjects were enrolled in an open, nonrandomized trial
investigating the pharmacokinetics of two different dosing regimens of
D0870 and assessing the safety of multiple oral doses of D0870 in
HIV-positive subjects and their ability to tolerate multiple oral
doses. Nine subjects received an initial loading dose of 50 mg,
followed by four once-daily maintenance doses of 10 mg. A further nine
subjects received an initial 200-mg loading dose followed by four daily maintenance doses of 25 mg. All subjects were fasting. A single loading
dose of 50 mg of D0870 resulted in a mean maximum concentration in
serum (Cmax) of 107 ± 32 ng/ml.
Concentrations in plasma were maintained by the 10-mg once-daily dosing
regimen as seen by the similar values of the area under the
concentration-time curve from 0 to 24 h following dosing on days 1 and 5 and a mean accumulation ratio close to unity (0.90). The terminal
plasma half-life of D0870 in plasma following dosing on day 5 ranged from 23 to 85 h (mean, 49 h). A single loading dose of
200 mg of D0870 resulted in a Cmax of 431 ± 186 ng/ml. Concentrations in plasma were again maintained by the
25-mg daily dosing regimen, with the mean accumulation ratio being close to unity (1.17). The terminal half-life of D0870 in plasma following dosing on day 5 of phase II of the study
ranged from 34 to 137 h (mean, 71 h). In addition, the
concentrations achieved in the plasma of these HIV-positive subjects
were similar to the values predicted from simulations based on data
derived from normal, healthy subjects. D0870 was well tolerated. No
serious adverse events were experienced during the course of the study, and all volunteers completed the trial. A total of 15 adverse events
were reported, but none were considered to be related to the
administration of D0870 and all had resolved by the end of the trial.
No changes in the hematology, clinical chemistry, or urinalysis
parameters were considered to be related to dosing with D0870.
No clinically significant changes in the electrocardiogram parameters
were noted during the trial. The data generated in this trial support
further investigation of these regimens with HIV-positive subjects
with fluconazole-susceptible or -resistant oropharyngeal candidosis.
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Pharmacokinetics of Two Multiple-Dosing Regimens of D0870 in
Human Immunodeficiency Virus-Positive Patients: a Phase I
Study
*
Corresponding author. Mailing address: Division of
Infectious Diseases (PL5), C.H.U. Saint-Pierre, rue Haute 322, B-1000
Brussels, Belgium. Phone: 32.2/535.41.30. Fax:
32.2/539.36.14. E-mail: nclumeck{at}ulb.ac.be.
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