Population pharmacokinetics of rosuvastatin: implications of renal impairment, race, and dyslipidaemia.
OBJECTIVE
To build the structural model of pharmacokinetics for rosuvastatin and evaluate the impact of demographic characteristics including renal function on its pharmacokinetic parameters.


METHODS
A population pharmacokinetic analysis of rosuvastatin in healthy volunteers, subjects with dyslipidaemia, and renal failure patients was performed using non-linear mixed-effects modelling and a two-compartment pharmacokinetic model with simultaneous first- and zero-order absorption. Demographic covariates, dyslipidaemic state and renal function were evaluated for their impact on pharmacokinetic parameters by step-wise additions or deletions using the likelihood ratio test.


RESULTS
Typical pharmacokinetic parameters were estimated for a healthy white male subject. For example, apparent oral clearance (CL/F) was estimated to be 257 L/h. Age, smoking status, weight, body surface area, and lean body mass had no significant effect on rosuvastatin pharmacokinetics. The model predicted that CL/F for subjects with creatinine clearance (CLCR) of 30 mL/min (moderate renal impairment) and of 50 mL/min (mild renal impairment) was 17% and 9.7% lower, respectively, relative to subjects with CLCR of 94 mL/min, the data set median value. CL/F was reduced by 71.1% and 43.7% in subjects with dyslipidaemia and in Asian subjects, respectively.


CONCLUSIONS
Reduction of CL/F of rosuvastatin is not considered clinically significant for patients with mild-to-moderate renal impairment. Rosuvastatin CL/F was reduced in subjects with dyslipidaemia, but it is important to realise that the safety/efficacy profile of rosuvastatin has been well established in this population. However, the potential for increased exposure in Asian subjects should be considered when initiating rosuvastatin treatment or increasing dose in this population.
Tzeng
Tsang-Bin
TB
AstraZeneca, Wilmington, DE 19850, USA. tsang-bin.tzeng@astrazeneca.com
Schneck
Dennis W
DW
Birmingham
Bruce K
BK
Mitchell
Patrick D
PD
Zhang
Harry
H
Martin
Paul D
PD
Kung
Li-Pin
LP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002851:Chromatography, High Pressure Liquid; D050171:Dyslipidemias / Q000188:drug therapy* / Q000378:metabolism; D005464:Fluorobenzenes / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D007668:Kidney / Q000503:physiopathology*; D008875:Middle Aged; D011743:Pyrimidines / Q000493:pharmacokinetics* / Q000627:therapeutic use; D044469:Racial Groups; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000493:pharmacokinetics* / Q000627:therapeutic use; D053719:Tandem Mass Spectrometry
D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium