A comparison of population and standard two-stage pharmacokinetic analyses of vigabatrin data

Vigabatrin (VGB), an irreversible inhibitor of GABA, is being developed as an add-on therapy for uncontrolled complex partial seizure. A single-dose study was conducted in three groups of subjects with normal, mild-to-moderate, and moderate-to-severe renal impairment to examine the effect of renal function on the pharmacokinetics of VGB. Serial blood samples were collected up to 60 h following a single 750 mg oral dose of VGB for the quantitation of drug concentrations. The plasma VGB concentration-time data were analyzed by mixed-effects modeling to estimate population pharmacokinetic parameters and to identify any significant demographic covariates. The parameters of VGB were also calculated by standard two-stage techniques and then compared to the results obtained using the mixed-effects analysis. Population VGB plasma concentration-time profiles were best described by a two-compartment model with zero-order absorption. Creatinine clearance was observed to significantly affect the oral clearance of VGB (p < 0.05), i.e. a linear increasing relationship existed between the two variables. Other demographic factors had no influence on VGB pharmacokinetics. There were agreements in the oral clearance, apparent volume of distribution during elimination, and half-life estimates calculated by both methods. In addition, the conventional technique identified a linear relationship between oral and creatinine clearances. In summary, mixed-effects modeling of serial vigabatrin data validated results determined by the standard two-stage technique.