Investigating clinical pharmacokinetics of brivaracetam by using a pharmacokinetic modeling approach

The development of technology and the processing speed of computing machines have facilitated the evaluation of advanced pharmacokinetic (PK) models, making modeling processes simple and faster. The present model aims to analyze the PK of brivaracetam (BRV) in healthy and diseased populations. A comprehensive literature review was conducted to incorporate the BRV plasma concentration data and its input parameters into PK-Sim software, leading to the creation of intravenous (IV) and oral models for both populations. The developed physiologically based pharmacokinetic (PBPK) model of BRV was then assessed using the visual predictive checks, mean observed/predicted ratios (R_obs/_pre), and average fold error for PK parameters including the maximum systemic concentration (C_max), the area under the curve at time 0 to t (AUC_0-∞), and drug clearance (CL). The PBPK model of BRV demonstrated that mean R_obs/_pre ratios of the PK parameters remained within the acceptable limits when assessed against a twofold error margin. Furthermore, model predictions were carried out to assess how AUC_0-∞ is affected following the administration of BRV in individuals with varying degrees of liver cirrhosis, ranging from different child-pugh (CP) scores like A, B, and C. Moreover, dose adjustments were recommended by considering the variations in C_max and CL in various kidney disease stages (mild to severe).