不同剂量匹伐他汀对小鼠缺血肢血流恢复的影响

目的：探讨不同剂量匹伐他汀对小鼠缺血肢血流恢复的影响,为临床应用合适剂量他汀类药物提供实验依据.方法：建立小鼠下肢缺血模型并分为对照组、匹伐他汀低剂量组及高剂量组.镉还原Griess法、生化检测法测定3组实验结束后血清一氧化氮代谢产物及肝肾功能等含量.激光多普勒血流仪测定3组投药前及术后双下肢血流.蛋白印迹杂交法检测各组双下肢血管内皮生长因子（VEGF）蛋白表达.结果：低剂量组实验结束后肝肾功能无明显变化,一氧化氮代谢产物明显高于另外2组,术后缺血肢血流恢复明显,缺血肢VEGF蛋白表达增强.高剂量组肾功能损伤明显高于对照组和低剂量组,一氧化氮代谢产物明显低于低剂量组,术后缺血肢血流恢复不明显,缺血肢VEGF蛋白表达低于低剂量组.结论：低剂量匹伐他汀促进了小鼠缺血肢血流的恢复.     

Novel statins: pharmacological and clinical results

Rosuvastatin (ZD4522) and pitavastatin (NK-104) are novel HMG-CoA reductase inhibitors with a peculiar pharmacological profile. In particular, they show a high potency in decreasing LDL-C and their catabolism is not mediated by the cytochrome P-450 3A4, thus reducing the potential for drug-drug interaction and improving the management of blood cholesterol. As the magnitude of LDL-C reduction is directly associated with the decrease in the incidence of myocardial infarction and mortality for CAD, statins with increased LDL-C lowering potency may ensure the achievement of target LDL-C levels and offer a more aggressive cholesterol control, further improving CAD morbidity and mortality.     

乳酸-羟基乙酸共聚物包载匹伐他汀纳米粒的制备及其对内皮祖细胞的增殖作用

制备乳酸-羟基乙酸共聚物(PLGA)包载匹伐他汀纳米粒,检测其形貌、粒径、载药量、包封率及体外释药特点,研究其对内皮祖细胞的增殖作用。采用溶剂扩散法制备PLGA包载的匹伐他汀纳米粒,扫描电镜观察纳米粒形貌,激光粒度仪测定粒径,高效液相色谱法检测并计算载药量、包封率,体外药物释放实验检测纳米粒的缓释效能,CCK8法检测空白PLGA纳米粒及匹伐他汀纳米粒对内皮祖细胞的活性影响。扫描电镜下匹伐他汀纳米粒呈圆球形,平均粒径在(230.1±45)nm,载药量与包封率分别为(10.00±1.83)%、(35.54±5.40)%,具备缓释性能,不同浓度空白PLGA纳米粒对内皮祖细胞活性均无影响,匹伐他汀纳米粒组(0.01、0.1 μmol/L)可显著改善内皮祖细胞的增殖活性,与同浓度匹伐他汀原药组相比差异显著。结果表明,溶剂扩散法可制备形态较好的匹伐他汀纳米粒,具备缓释性能,载体材料具有较好的细胞生物相容性,匹伐他汀纳米粒显著改善内皮祖细胞增殖活性。     

Pharmacokinetics of pitavastatin in subjects with Child-Pugh A and B cirrhosis

AIM: Lipid lowering therapy with 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors is increasingly used for the prevention of cardiovascular events, but they should be used with caution in patients with impaired liver function. We therefore studied the pharmacokinetics of pitavastatin in patients with liver cirrhosis. METHODS: Plasma concentrations of pitavastatin were determined after administration of 2 mg single-dose pitavastatin to 12 male patients with liver cirrhosis (six Child-Pugh grade A and six grade B). These results were compared with the single-dose pharmacokinetic results obtained from six male volunteers without liver disease. RESULTS: Administration of 2 mg single-dose pitavastatin to patients with Child-Pugh grade A and grade B cirrhosis resulted in a 1.19- and 2.47-fold increase in Cmax and 1.27- and 3.64-fold increase in AUCt, respectively, when compared with normal subjects. The geomean Cmax of pitavastatin was 59.5 ng ml(-1), 70.7 ng ml(-1) and 147.1 ng ml(-1) in the control, Child-Pugh grade A and Child-Pugh grade B groups, respectively. The geomean AUCt of pitavastatin in the three groups was 121.2 ng h(-1) ml(-1), 154.2 ng h(-1) ml(-1) and 441.7 ng h(-1) ml(-1), respectively. The geomean Cmax of pitavastatin lactone was 20.3 ng ml(-1), 19.1 ng ml(-1) and 9.9 ng ml(-1) in the control, Child-Pugh grade A and grade B groups, respectively. The AUCt of pitavastatin lactone was 120.2 h(-1) ml(-1), 108.8 h(-1) ml(-1) and 87.5 h(-1) ml(-1), respectively. CONCLUSION: The plasma concentration of pitavastatin is increased in patients with liver cirrhosis. In such patients, caution is required, although dose reduction may not be necessary in Child-Pugh A cirrhosis.     

降血脂新药匹伐他汀

匹伐他汀是新一代他汀类药物.该药不仅具有较强的HMG-CoA还原酶抑制作用,而且呈肝细胞选择性,药动学性质优异,安全性好,已被制药界誉为是"超级他汀".现就匹伐他汀的药理及临床应用进行综述.     

An evaluation of pitavastatin for the treatment of hypercholesterolemia

Introduction: Statins are the first line of therapy to reduce low-density lipoprotein cholesterol (LDL-C) in order to decrease cardiovascular events. Pitavastatin is the latest statin to be introduced to the market.

Areas covered: In this article, the authors review the efficacy, safety, and tolerability of pitavastatin. The authors also review a recent cardiovascular outcome study.

Expert opinion: Pitavastatin produces dose-dependent reductions in LDL-C at lower doses than other statins. The maximum approved dose of 4 mg reduces LDL-C by about 40–49% in different patient groups and is equivalent to atorvastatin 20 mg in this effect. Pitavastatin undergoes minimal metabolism so drug–drug interactions are less likely than with many other statins, but it can interact with some drugs that inhibit drug transporters. Compared with other statins, it has been associated with greater increases in high-density lipoprotein cholesterol and it was found to be less likely to cause new onset diabetes. In a recent study in Japanese patients with stable coronary artery disease, pitavastatin 4 mg was more effective than pitavastatin 1 mg in reducing cardiovascular events. Therefore, the highest dose may be preferred in high-risk patients.     

Pleiotropic effects of pitavastatin

3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are established first line treatments for hypercholesterolaemia. In addition to the direct effects of statins in reducing concentrations of atherogenic low density lipoprotein cholesterol (LDL-C), several studies have indicated that the beneficial effects of statins may be due to some of their cholesterol-independent, multiple (pleiotropic) effects which may differ between different members of the class. Pitavastatin is a novel synthetic lipophilic statin that has a number of pharmacodynamic and pharmacokinetic properties distinct from those of other statins, which may underlie its potential pleiotropic benefits in reducing cardiovascular risk factors. This review examines the principal pleiotropic effects of pitavastatin on endothelial function, vascular inflammation, oxidative stress and thrombosis. The article is based on a systematic literature search carried out in December 2010, together with more recent relevant publications where appropriate. The available data from clinical trials and in vitro and animal studies suggest that pitavastatin is not only effective in reducing LDL-C and triglycerides, but also has a range of other effects. These include increasing high density lipoprotein cholesterol, decreasing markers of platelet activation, improving cardiac, renal and endothelial function, and reducing endothelial stress, lipoprotein oxidation and, ultimately, improving the signs and symptoms of atherosclerosis. It is concluded that the diverse pleiotropic actions of pitavastatin may contribute to reducing cardiovascular morbidity and mortality beyond that achieved through LDL-C reduction.     

HPLC-MS/MS法测定人血浆中匹伐他汀钙的浓度及应用

目的建立高效液相色谱-质谱（HPLC-MS/MS）法测定人血浆中匹伐他汀钙的浓度,评价2种匹伐他汀钙片在人体内的生物等效性。方法血浆中加入内标瑞舒伐他汀后,甲基叔丁基醚萃取,选用Venusil MP-C18（150 mm×2.1 mm,5μm,Agela）色谱柱,流动相为30 mmol·L-1乙酸铵（含0.1%甲酸）-甲醇（25：75）,流速0.4 mL·min-1,进样体积为20μL,柱温为40℃。以多重离子反应监测模式进行检测：m/z421.9→m/z290.1（匹伐他汀）,m/z482.2→m/z258.2（瑞舒伐他汀）。结果匹伐他汀钙的线性范围为0.110～56.0μg·L-1,本方法灵敏、稳定、特异性高,可应用于生物等效性研究。结论该方法重复性好,可以准确测量人血浆中匹伐他汀钙的浓度,适用于临床匹伐他汀的生物等效性研究。     

HPLC法测定匹伐他汀钙中6种有关物质

目的建立了高效液相色谱梯度洗脱法测定匹伐他汀钙中有关物质的方法。方法采用C18（4.6mm×250mm,5μm）色谱柱,以醋酸盐缓冲液（取醋酸钠0.15g,冰醋酸0.5mL,加水稀释至1000mL）为流动相A,乙腈为流动相B,梯度洗脱条件：0～20min,A为56%;20～40min,A为56%→30%;40～60min,A为30%;以1.0mL.min-1的流速进行梯度洗脱;检测波长为245nm。结果匹伐他汀钙与各有关物质的分离度良好,匹伐他汀钙及杂质Ⅰ、Ⅱ、Ⅲ、Ⅴ、Ⅵ的检测限均为0.04μg.mL-1。结论所建立的方法简便、灵敏、准确,可用于匹伐他汀钙有关物质的测定。