title: Pharmacokinetics and pharmacodynamics of intravenous and inhaled fluticasone furoate in healthy Caucasian and East Asian subjects.
abstract: OBJECTIVE
  The aim of the study was to evaluate the pharmacokinetics (PK) of inhaled and intravenous (i.v.) fluticasone furoate (FF) in healthy Caucasian, Chinese, Japanese and Korean subjects.
  
  
  METHODS
  This was an open label, randomized, two way crossover study in healthy Caucasian, Chinese, Japanese and Korean subjects (n = 20 per group). Inhaled FF (200 μg for 7 days, then 800 μg for 7 days from a dry powder inhaler [DPI]) was administered in one treatment period and i.v.FF (250 μg infusion) in the other. FF PK and serum cortisol (inhaled 200 μg only) were compared between the ethnic groups using analysis of variance. P450 CYP3A4 activity and safety were also assessed.
  
  
  RESULTS
  Ethnic differences in i.v. FF PK were accounted for by body weight differences. CYP3A4 activity was similar across the groups. Higher FF systemic exposure was seen following inhaled dosing in Chinese, Japanese and Korean subjects compared with Caucasian subjects. Absolute bioavailability was greater (36%-55%) in all East Asian groups than for Caucasian subjects following inhaled FF 800 μg. Deconvolution analysis suggested inhaled FF resided in the lung of East Asian subjects longer than for Caucasians (time for 90% to be absorbed [t90]: 29.1-30.8 h vs. 21.4 h). In vitro simulation method predicted comparable delivered lung dose across ethnic groups. Serum cortisol weighted mean was similar between Caucasians and Chinese or Koreans, while in Japanese was on average 22% lower than in Caucasians. All FF treatments were safe and well tolerated.
  
  
  CONCLUSIONS
  Modestly higher (<50%) FF systemic exposure seen in East Asian subjects following inhaled dosing was not associated with a clinically significant effect on serum cortisol, suggesting that a clinical dose adjustment in East Asian subjects is not required.
authors.affiliation: GlaxoSmithKline R&D, Stevenage, Hertfordshire, SG1 2NY, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Allen
authors.forename: Joanne
authors.initials: J
authors.lastname: Bal
authors.forename: Anne
authors.initials: A
authors.lastname: Cheesbrough
authors.forename: Melanie
authors.initials: M
authors.lastname: Hamilton
authors.forename: Rodger
authors.initials: R
authors.lastname: Kempsford
mesh_terms: D000280:Administration, Inhalation; D000730:Androstadienes / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D044466:Asian People; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D044465:White People
chemical_list: D000730:Androstadienes; C523187:fluticasone furoate
keywords: Caucasian; East Asian; fluticasone furoate; healthy subjects; pharmacodynamics; pharmacokinetics