Progress in strategies for dosage regimen individualization

Area of Science:

• Pharmacokinetics and Pharmacodynamics
• Clinical Pharmacology
• Drug Dosing Optimization

Background:

• Individualized dosing is crucial for improving patient outcomes.
• Traditional methods for dosage individualization can be complex and not fully integrated into clinical practice.

Purpose of the Study:

• To describe current methods for dosage individualization in clinical practice.
• To propose kinetic nomograms as a reliable alternative to traditional Bayesian methods.
• To evaluate the performance of proposed methods using clinical and simulation data.

Main Methods:

• Bayesian methods were applied for high-dose methotrexate and amikacin dosage individualization.
• Kinetic nomograms were used to adjust sirolimus doses.
• Methods were evaluated using real-world therapeutic drug monitoring data and simulations.

Main Results:

• Bayesian methods accurately estimated individual pharmacokinetic parameters for methotrexate and amikacin using limited samples.
• Kinetic nomograms effectively guided sirolimus blood levels within the therapeutic window using only two samples.
• The proposed methods demonstrated reliable performance in achieving therapeutic goals.

Conclusions:

• Kinetic nomograms offer a simple, quick, and reliable bedside alternative to complex Bayesian methods for drug dosage individualization.
• Recent developments based on population approaches simplify dosage adjustment methodologies.
• These advancements facilitate the integration of personalized dosing strategies into routine clinical care.