Clinical pharmacology of exogenously administered alkaline phosphatase

P. Pickkers*, F. Snellen, P. Rogiers, J. Bakker, P. Jorens, J. Meulenbelt, H. Spapen, J. E. Tulleken, R. Lins, S. Ramael, M. Bulitta, J. G. van der Hoeven

*Corresponding author for this work

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    Abstract

    To evaluate the clinical pharmacology of exogenous alkaline phosphatase (AP).

    Randomized, double-blind, placebo-controlled sequential protocols of (1) ascending doses and infusion duration (volunteers) and (2) fixed dose and duration (patients) were conducted at clinical pharmacology and intensive care units. A total of 103 subjects (67 male volunteers and 36 patients with severe sepsis) were administered exogenous, 10-min IV infusions (three ascending doses) or 24-72 h continuous (132.5-200 U kg(-1) 24 h(-1)) IV infusion with/without preceding loading dose and experimental endotoxemia for evaluations of pharmacokinetics, pharmacodynamics, safety parameters, antigenicity, inflammatory markers, and outcomes.

    Linearity and dose-proportionality were shown during 10-min infusions. The relatively short elimination half-life necessitated a loading dose to achieve stable enzyme levels. Pharmacokinetic parameters in volunteers and patients were similar. Innate immunity response was not significantly influenced by AP, while renal function significantly improved in sepsis patients.

    The pharmacokinetics of exogenous AP is linear, dose-proportional, exhibit a short half-life, and are not influenced by renal impairment or dialysis.

    Original languageEnglish
    Pages (from-to)393-402
    Number of pages10
    JournalEuropean Journal of Clinical Pharmacology
    Volume65
    Issue number4
    DOIs
    Publication statusPublished - Apr-2009

    Keywords

    • Alkaline phosphatase
    • Clinical trial
    • Inflammation
    • Volunteer
    • Sepsis
    • Renal failure
    • PHOSPHODIESTERASE ACTIVITY
    • SEPTIC SHOCK
    • INFLAMMATION
    • EXPRESSION
    • ADENOSINE
    • SEPSIS

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