Observational studyPharmaceutical research2015
The Pharmacokinetics of the CYP3A Substrate Midazolam in Morbidly Obese Patients Before and One Year After Bariatric Surgery.
Observational study in Pharmaceutical research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Effects of Bariatric Surgery on the Pharmacokinetics of Cardiovascular Drugs: A Systematic Review and Meta-Analysis.Obesity surgery · 2026Pooled it
- The effect of obesity, macronutrients, fasting and nutritional status on drug-metabolizing cytochrome P450s: a systematic review of current evidence on human studies.European journal of nutrition · 2021Pooled it
- The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2019Pooled it
- Short- and long-term effects of body weight, calorie restriction and gastric bypass on CYP1A2, CYP2C19 and CYP2C9 activity.British journal of clinical pharmacology · 2022Trial
- Midazolam Pharmacokinetics in Obese and Non-obese Children and Adolescents.Clinical pharmacokinetics · 2020Trial
- Nutritional Status Differentially Alters Cytochrome P450 3A4 (CYP3A4) and Uridine 5'-Diphospho-Glucuronosyltransferase (UGT) Mediated Drug Metabolism: Effect of Short-Term Fasting and High Fat Diet on Midazolam Metabolism.European journal of drug metabolism and pharmacokinetics · 2018Trial
- Influence of Morbid Obesity on the Pharmacokinetics of Morphine, Morphine-3-Glucuronide, and Morphine-6-Glucuronide.Clinical pharmacokinetics · 2017Trial
- Hypoalbuminaemia and decreased midazolam clearance in terminally ill adult patients, an inflammatory effect?British journal of clinical pharmacology · 2017Trial
- Molecular Mechanisms Affecting Statin Pharmacokinetics after Bariatric Surgery.International journal of molecular sciences · 2024Review
- Impact of bariatric surgery on cytochrome P 450 enzyme activity.Frontiers in pharmacology · 2024Review
- Digoxin Pharmacokinetics in Patients with Obesity Before and After a Gastric Bypass or a Strict Diet Compared with Normal Weight Individuals.Clinical pharmacokinetics · 2024Article
- The Effects of Bariatric Surgery on Pharmacokinetics of Drugs: a Review of Current Evidence.Current nutrition reports · 2023Review
- Outcomes of Bariatric Surgery in People With Human Immunodeficiency Virus: A Retrospective Analysis From the ATHENA Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs.Obesity surgery · 2023Review
- Outcomes of modern antiretroviral therapy in obese individuals living with HIV.The Journal of antimicrobial chemotherapy · 2022Article
- Dexamethasone exposure in normal-weight and obese hospitalized COVID-19 patients: An observational exploratory trial.Clinical and translational science · 2022Observational
- Drug absorption in bariatric surgery patients: A narrative review.Health science reports · 2022Review
- Clinical Pharmacokinetics and Pharmacodynamics of the Selective Progesterone Receptor Modulator Vilaprisan: A Comprehensive Overview.Clinical pharmacokinetics · 2022Review
- Psychotropic Medications in Metabolic and Bariatric Surgery: Research Updates and Clinical Considerations.Current psychiatry reports · 2022Review
- Short- and long-term effects of body weight loss following calorie restriction and gastric bypass on CYP3A-activity - a non-randomized three-armed controlled trial.Clinical and translational science · 2022Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBariatric surgery is nowadays commonly applied as treatment for morbid obesity (BMI > 40 kg/m(2)). As information about the effects of this procedure on a drug's pharmacokinetics is limited, we aimed to evaluate the pharmacokinetics of CYP3A probe substrate midazolam after oral and intravenous administration in a cohort of morbidly obese patients that was studied before and 1 year post bariatric surgery.
methodsTwenty morbidly obese patients (aged 26-58 years) undergoing bariatric surgery participated in the study of which 18 patients returned 1 year after surgery. At both occasions, patients received 7.5 mg oral and 5 mg intravenous midazolam separated by 160 ± 48 min. Per patient and occasion, a mean of 22 blood samples were collected. Midazolam concentrations were analyzed using population pharmacokinetic modeling.
resultsOne year after bariatric surgery, systemic clearance of midazolam was higher [0.65 (7%) versus 0.39 (11%) L/min, mean ± RSE (P < 0.01), respectively] and mean oral transit time (MTT) was faster [23 (20%) versus 51 (15%) minutes (P < 0.01)], while oral bioavailability was unchanged (0.54 (9%)). Central and peripheral volumes of distribution were overall lower (P < 0.05).
conclusionsIn this cohort study in morbidly obese patients, systemic clearance was 1.7 times higher 1 year after bariatric surgery, which may potentially result from an increase in hepatic CYP3A activity per unit of liver weight. Although MTT was found to be faster, oral bioavailability remained unchanged, which considering the increased systemic clearance implies an increase in the fraction escaping intestinal first pass metabolism.
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