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1996-03-30
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Document 1057
DOCN M9651057
TI Clinical pharmacokinetics of adefovir in human immunodeficiency virus
type 1-infected patients.
DT 9505
AU Cundy KC; Barditch-Crovo P; Walker RE; Collier AC; Ebeling D; Toole J;
Jaffe HS; Gilead Sciences, Inc., Foster City, California 94404, USA.
SO Antimicrob Agents Chemother. 1995 Nov;39(11):2401-5. Unique Identifier :
AIDSLINE MED/96139529
AB The pharmacokinetics and bioavailability of adefovir
[9-[2-(phosphonomethoxy)ethyl]adenine] were examined at two dose levels
in three phase I/II studies in 28 human immunodeficiency type 1-infected
patients. The concentrations of adefovir in serum following the
intravenous infusion of 1.0 or 3.0 mg/kg of body weight were dose
proportional and declined biexponentially, with an overall mean +/-
standard deviation terminal half-life of 1.6 +/- 0.5 h (n = 28).
Approximately 90% of the intravenous dose was recovered unchanged in the
urine in 12 h, and more than 98% was recovered by 24 h postdosing. The
overall mean +/- standard deviation total serum clearance of the drug
(223 +/- 53 ml/h/kg; n = 25) approximated the renal clearance (205 +/-
78 ml/h/kg; n = 20), which was significantly higher (P < 0.01) than the
baseline creatinine clearance in the same patients (88 +/- 18 ml/h/kg; n
= 25). Since adefovir is essentially completely unbound in plasma or
serum, these data indicate that active tubular secretion accounted for
approximately 60% of the clearance of adefovir. The steady-state volume
of distribution of adefovir (418 +/- 76 ml/kg; n = 28) suggests that the
drug was distributed in total body water. Repeated daily dosing with
adefovir at 1.0 mg/kg/day (n = 8) and 3.0 mg/kg/day (n = 4) for 22 days
did not significantly alter the pharmacokinetics of the drug; there was
no evidence of accumulation. The oral bioavailability of adefovir at a
3.0-mg/kg dose was < 12% (n = 5) on the basis of the concentrations in
serum or 16.4% +/- 16.0% on the basis of urinary recovery. The
subcutaneous bioavailability of adefovir at a 3.0-mg/kg dose was 102%
+/- 8.3% (n = 5) on the basis of concentrations in serum or 84.8% +/-
28.5% on the basis of urinary recovery. These data are consistent with
preclinical observations in various species.
DE Adenine/*ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE/
PHARMACOKINETICS Administration, Oral Adult Antiviral
Agents/ADMINISTRATION & DOSAGE/*PHARMACOKINETICS Biological
Availability Female Half-Life Human HIV Infections/DRUG
THERAPY/*METABOLISM/VIROLOGY *HIV-1 Injections, Intravenous
Injections, Subcutaneous Male Middle Age Protein Binding Support,
U.S. Gov't, P.H.S. CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).