Orientador: Ronilson Agnaldo Moreno / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-12T08:52:50Z (GMT). No. of bitstreams: 1 Mazuqueli_AnaCristina_M.pdf: 7140095 bytes, checksum: c193ad443d7fe35cf3c6d7b25f3175e8 (MD5) Previous issue date: 2008 / Resumo: O objetivo deste estudo foi avaliar a bioequivalência de duas formulações de acetato de ciproterona e etinilestradiol em drágea vs comprimido (Selene® comprimidos, Laboratório Eurofarma Ltda., formulação Teste e Diane® 35, Schering do Brasil, como Referência) após administração oral em 48 voluntárias adultas sadias. O estudo foi do tipo aberto, randomizado com duas fases, em que as voluntárias receberam uma dose única de acetato de ciproterona 2mg e etinilestradiol 0,035mg . As amostras de plasma foram obtidas em um período total de 240h. As concentrações plasmáticas de acetato de ciproterona e etinilestradiol foram analisadas por um método baseado na cromatografia líquida acoplada ao espectrômetro de massa usando como fonte de ionização photospray ( LC-MS/MS ) utilizando finasterida como padrão interno do acetato de ciproterona e 17-a-etinilestradiol-D4 como padrão interno do etinilestradiol. A concentração plasmática do acetato de ciproterona não teve diferença significante após a administração de ambas as formulações (formulação teste e referência do Diane®35). A média geométrica da razão entre o medicamento teste e referência com 90% IC, foi 90,66% (84,39% - 97,40% ) para Cmax, 96,20% (90,45% - 102,33%) para ASC0-240 e 95,86% (89,81% - 102,31%) para ASC0-inf. Já para o Etinilestradiol a média geométrica da razão entre o medicamento teste e referência com 90% IC, foi de 109,92% (IC 90% = 102,67% - 117,69% ) para Cmax, 90,63% (83,75% - 98,08%) para ASC0-120 e 83,85% (69,98% - 100,47%) para ASC0-inf. Diante dos resultados encontrados de Cmax e ASC0-t e estando dentro do intervalo de confiança entre 80% e 125% proposto pela Agência Nacional de Vigilância Sanitária (ANVISA) e pelo Food and Drug Administration (FDA), conclui-se que o Acetato de Ciproterona 2mg e o Etinilestradiol 0.035mg da Eurofarma Laboratórios Ltda. em comprimido é bioequivalente ao Diane®35 da Schering do Brasil, de acordo com sua taxa e extensão de absorção. / Abstract: The aim of this study was to assess the bioequivalence of two cyproterone acetate + ethinylestradiol tablet formulations (Selene® tablet formulation elaborated by Eurofarma Laboratórios Ltda., Brazil, as test formulation, and Diane ® 35 tablet formulation by Schering of Brazil, as reference formulation) after their oral administration to 48 healthy adult females. The study was conducted using an open, randomized two-period crossover design, in which twenty-four healthy volunteers received a single oral dose of cyproterone acetate + ethinylestradiol (2mg + 0.035mg) tablet. Plasma samples were obtained over a 240-hour period. Plasma cyproterone acetate + ethinylestradiol concentrations were analyzed by a method based on liquid chromatography by positive-ion photospray ionization (LC-MS/MS), using finasteride as internal standard of cyproterone acetate and 17-a-ethinyl estradiol-D4 as internal ethinylestradiol standard. The plasma concentration of CYP acetate did not differ significantly after the administration of both formulations (test formulation and the reference Diane®), according to the geometric mean ratio between the test and reference formulations, with 90% CI: 90.66% (84.39% - 97.40% ) for Cmax, 96.20% (90.45% - 102.33%) for ASC0-240 and 95.86% (89.81% - 102.31%) for ASC0-inf. Conversely, the geometric mean ratio between the test and reference formulations for ethinylestradiol, with 90% CI, was 109.92% (CI 90% = 102.67% - 117.69% ) for Cmax, 90.63% (83.75% - 98.08%) for ASC0-120 and 83.85% (69.98% - 100.47%) for ASC0-inf. Considering the results of Cmax and ASC0-t within the confidence interval between 80% and 125% proposed by the Brazilian National Agency for Sanitary Surveillance (ANVISA) and for the US Food and Drug Administration (FDA), it was concluded that the cyproterone acetate 2mg and ethinylestradiol 0.035mg by Eurofarma Laboratórios Ltda. in tablet is bioequivalent to the Diane®35 by Schering of Brazil, according to its absorption and extension rate. / Mestrado / Mestre em Farmacologia

Σκοπός: η μελέτη της επίδρασης εξάμηνης θεραπείας με από του στόματος αντισυλληπτικό δισκίο περιέχον 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης στη γλοιότητα πλάσματος νέων γυναικών με σύνδρομο πολυκυστικών ωοθηκών. Σχεδίαση: Η γλοιότητα πλάσματος μετρήθηκε σε ασθενείς με σύνδρομο πολυκυστικών ωοθηκών πριν και 6 μήνες μετά από τη χορήγηση αντισυλληπτικού δισκίου περιέχοντος 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης. Η μέτρηση της γλοιότητας έγινε σε ιξωδόμετρο τύπου 53610/I SCHOTT-Instruments, Mainz στους 37ο C. Ασθενείς: Οι ασθενείς στρατολογήθηκαν από το τμήμα Αναπαραγωγικής Ενδοκρινολογίας της Μαιευτικής - Γυναικολογικής Κλινικής του Πανεπιστημιακού Νοσοκομείου Πατρών Ελλάδας. Στη μελέτη περιλήφθηκαν 66 νέες γυναίκες με σύνδρομο πολυκυστικών ωοθηκών. Βασικοί προσδιορισμοί: Γλοιότητα πλάσματος Αποτελέσματα: Στις ασθενείς ως σύνολο, η γλοιότητα πλάσματος ήταν 1.249±0.049 mm2/s (n=66). Μετά από 6 μήνες θεραπείας με από του στόματος αντισυλληπτικό δισκίο περιέχον 35μg αιθινυλ-οιστραδιόλης και 2mg οξικής κυπροτερόνης, η γλοιότητα πλάσματος αυξήθηκε σε 1.268±0.065 mm2/s (p=0.038). Η διαφορά στη γλοιότητα πλάσματος πριν και 6 μήνες μετά τη θεραπεία (Δ Γλοιότητας) ήταν 0,01864±,071452 mm2/s. Η Δ Γλοιότητας σχετιζόταν με τη Δ Ινωδογόνου (r=0.270, p=0.046), τη Δ Αιματοκρίτη (r=0.514, p=0.09) και τη Δ Τριγλυκεριδίων (r=0.292, p=0.021). Συμπέρασμα: Νέες γυναίκες με σύνδρομο πολυκυστικών ωοθηκών εμφάνισαν αυξημένη γλοιότητα πλάσματος μετά από θεραπεία με από του στόματος αντισυλληπτικό, το οποίο θα πρέπει για το λόγο αυτό να χρησιμοποιείται με προσοχή στον εν λόγω πληθυσμό. / Objectives: To investigate the influence of 6 months of treatment with an oral contraceptive (OC) containing 35μg ethinyl estradiol and 2mg cyproterone acetate on plasma viscosity in young women with PCOS. Design: PCOS patients were assessed for plasma viscosity before and after 6 months of treatment with an OC containing 35μg ethinyl estradiol and 2mg cyproterone acetate. Plasma viscosity was determined by a viscometer Type 53610/I SCHOTT-Instruments, Mainz at 37o C. Settings: Subjects were recruited from the Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology at the University Hospital of Patras, Greece. Patients: The study included 66 young PCOS women. Main Outcome measures: Plasma viscosity. Results: In PCOS women as a whole, plasma viscosity at baseline was 1.249±0.049 mm2/s (n=66). After 6 months of treatment with an oral contraceptive containing 35μg ethinyl estradiol and 2mg cyproterone acetate, plasma viscosity increased to 1.268±0.065 mm2/s (p=0.038). The difference between plasma viscosity before and after 6 months of treatment with an oral contraceptive containing 35μg ethinyl estradiol and 2mg cyproterone acetate (Δviscosity) was 0,01864±,071452 mm2/s. Δviscosity was related to Δfibrinogen (r=0.270, p=0.046), to Δhaematocrit (r=0.514, p=0.09) and to Δtriglycerides (r=0.292, p=0.021). Conclusion: Young PCOS women presented an increased plasma viscosity under OC treatment, which therefore should be used with caution.