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Published on: March 16, 2019
A dynamic pharmacometric framework defining the relationship between ivermectin exposure and mosquito lethality
Richard M Hoglund1,2, Kevin C Kobylinski3,4, Podjanee Jittamala3,5
1Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. richard.hoglund@ndm.ox.ac.uk.
Ivermectin effectively kills mosquitoes, with its pharmacokinetic properties quantified. This pharmacometric framework aids in evaluating ivermectin for malaria vector control.
Area of Science:
- Pharmacology
- Entomology
- Tropical Medicine
Background:
- Ivermectin is used for neglected tropical diseases and shows mosquito-lethal effects.
- Quantitative data on ivermectin's pharmacokinetics and mosquito toxicity is lacking.
Purpose of the Study:
- To quantitatively describe the relationship between ivermectin's pharmacokinetic properties and its mosquito-lethal effects.
- To evaluate ivermectin as a potential tool for malaria vector control.
Main Methods:
- Two healthy volunteer trials in Thailand assessed ivermectin pharmacokinetics and mosquito-lethal effects.
- Nonlinear mixed-effect modeling and a parent-metabolite model were used for data analysis.
- A sigmoidal Emax model integrated pharmacokinetic profiles with mosquito mortality data.
Main Results:
- Ivermectin co-administration with dihydroartemisinin-piperaquine reduced elimination clearance and absorption, increasing exposure.
- Significant differences in ivermectin distribution volume were observed between sexes.
- The developed models accurately described mortality in Anopheles dirus and An. minimus mosquitoes.
Conclusions:
- Ivermectin and its metabolites demonstrate effective mosquito-lethal effects.
- The pharmacometric framework can support the use of ivermectin in malaria elimination strategies.
- Further evaluation of ivermectin as a vector-control agent is warranted.
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Pharmacokinetic–Pharmacodynamic Relationship: Exposure, Response and Effect
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Pharmacokinetic–Pharmacodynamic Relationship: Dose to Pharmacological Effect
Pharmacodynamic Models: Overview
Pharmacodynamic Models: Direct Effect Model and Indirect Response Model
Pharmacokinetic–Pharmacodynamic Relationship: Model Components

