Lamotrigine in children and adolescents: the impact of age on its serum concentrations and on the extent of drug interactions
Lamotrigine in children and adolescents: the impact of age on its serum concentrations and on the extent of drug interactions
复制标题
儿童和青少年的拉莫三嗪：年龄对其血清浓度和药物相互作用程度的影响
DOI：
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发表时间：
2007
影响因子：
2.9
通讯作者：
O. Spigset
中科院分区：
文献类型：
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作者：
Arne Reimers;E. Skogvoll;Janne Kutschera Sund;O. Spigset
目的探讨年龄和与其他药物的共同治疗对拉莫三嗪在儿童和青少年的血清concentrations.MethodsA审查拉莫三嗪在我们的实验室进行的常规血清浓度测量，共744例血清样本从296个主题（110名男性，186名女性，年龄：2-19岁）适合统计分析。主要结果变量是剂量校正的拉莫三嗪血清浓度，表示为拉莫三嗪浓度/剂量（C/D）比。一个线性混合模型，允许从同一患者的多个观察结果被用来识别和量化的影响因素的影响拉莫三嗪C/D ratio.ResultsAccording to the model，拉莫三嗪C/D ratio decreases by 6% per year of age.发现丙戊酸盐和左乙拉西坦可升高拉莫三嗪C/D比值，而以下联合用药可降低该比值：卡马西平、氯巴占、氟西汀、氯硝西泮和炔雌醇。卡马西平的作用随年龄增长而减弱。没有性别差异detected.ConclusionsAge是一个重要的因素，就拉莫三嗪在儿童和青少年的药代动力学和药物相互作用的程度。在该人群中，老年人需要比年轻人更高的剂量才能达到相同的血清浓度。
ObjectiveTo investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents.MethodsA review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2–19 years) suitable for statistical analysis. The primary outcome variable was the dose-corrected lamotrigine serum concentration, expressed as the lamotrigine concentration/dose (C/D) ratio. A linear mixed model that allowed multiple observations from the same patient was used to identify and quantify the effect of factors influencing the lamotrigine C/D ratio.ResultsAccording to the model, the lamotrigine C/D ratio decreases by 6% per year of age. Valproate and levetiracetam were found to raise the lamotrigine C/D ratio, whereas the following co-medications reduced it: carbamazepine, clobazam, fluoxetine, clonazepam and ethinyl estradiol. The effect of carbamazepine decreased with increasing age. No gender difference was detected.ConclusionsAge is an important factor with respect to the pharmacokinetics and the extent of drug interactions of lamotrigine in children and adolescents. In this population, older individuals will need higher doses than younger ones in order to achieve the same serum concentrations.