Dose proportionality of treprostinil sodium administered by continuous subcutaneous and intravenous infusion

J Clin Pharmacol. 2008 Jan;48(1):19-25. doi: 10.1177/0091270007309708.

Abstract

This study assessed the relationship between dose and plasma concentration following administration of treprostinil sodium infusion therapy in pulmonary arterial hypertension patients. This was a multicenter, open-label, multiple-cohort, steady-state, pharmacokinetic study in subjects with pulmonary arterial hypertension receiving treprostinil by continuous intravenous or subcutaneous infusion at doses between 10 and 125 ng/kg/min. A blood sample was obtained from each patient at steady state and analyzed via a liquid chromatography/tandem mass spectrometry method. Forty-nine subjects receiving treprostinil were enrolled. Treprostinil doses ranged from 12.1 to 125 ng/kg/min; treprostinil plasma concentrations ranged from 14.9 to 18 248 pg/mL. Linear regression analysis revealed a correlation between treprostinil dose and treprostinil plasma concentration with an R2 value of 0.561. Using a power model to assess dose proportionality, the estimated nonproportionality parameter was 0.641 (95% confidence interval: 0.083-1.199), reflecting consistency with dose proportionality. Subset linear regression analysis, which excluded 2 subjects with anomalous treprostinil plasma concentrations, increased the R2 value to 0.796. Using a power model to assess dose proportionality of this subset, the estimated nonproportionality parameter was 0.941 (95% confidence interval: 0.809-1.073). This study supports previous findings of linearity at lower doses up to 15 ng/kg/min and demonstrates linearity at treprostinil doses up to 125 ng/kg/min.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / pharmacokinetics*
  • Calcium Channel Blockers / administration & dosage
  • Calcium Channel Blockers / therapeutic use
  • Chromatography, Liquid
  • Digoxin / administration & dosage
  • Digoxin / therapeutic use
  • Diuretics / administration & dosage
  • Diuretics / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Epoprostenol / administration & dosage
  • Epoprostenol / analogs & derivatives*
  • Epoprostenol / blood
  • Epoprostenol / pharmacokinetics
  • Female
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / metabolism
  • Infusions, Intravenous
  • Injections, Subcutaneous
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Oxygen / administration & dosage
  • Oxygen / therapeutic use
  • Phosphodiesterase 5 Inhibitors
  • Regression Analysis

Substances

  • Anticoagulants
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Diuretics
  • Phosphodiesterase 5 Inhibitors
  • Digoxin
  • Epoprostenol
  • treprostinil
  • Oxygen