早期在家测量阿达利穆马布度以指导抗TNF精确剂量:试点研究
Paul A G de Klaver1, Ron J Keizer2, Rob Ter Heine3
1Department of Clinical Pharmacy and Pharmacology, Máxima Medical Center, 5504 DB, Veldhoven, The Netherlands. p.deklaver@mmc.nl.
European journal of drug metabolism and pharmacokinetics
|June 15, 2023
概括
使用人口药动力学模型预测治疗早期的阿达利穆马布水平可以改善类风湿性和炎症性肠道疾病的治疗. 这有助于避免剂量不足,并确保更好的疾病控制.
科学领域:
- 药理动力学和治疗药物监测
- 免疫学和风湿病学
- 胃肠病学 胃肠病学
背景情况:
- 低剂量阿达利穆马布与风湿性和炎症性肠道疾病治疗结果不佳有关.
- 精确的治疗药物监测对于优化阿达利穆马布治疗至关重要.
- 药物度的早期预测可以指导剂量调整.
研究的目的:
- 使用基于人口药理动力学 (PPK) 模型的贝叶斯预测来预测稳定状态的阿达利穆马布度.
- 评估在治疗的诱导阶段早期预测阿达利穆马布水平的可行性.
- 评估PPK模型在患有风湿性疾病和炎症性肠病 (IBD) 的患者的预测性能.
主要方法:
- 在文献中搜索相关的阿达利穆马布药理动力学模型.
- 使用患者数据对选定的PPK模型的适用性评估.
- 卷度吸收微样采集用于采集阿达利穆马布的峰值和低谷样本.
- 贝叶斯预测用于从早期样本中预测稳定状态度.
- 使用平均预测误差 (MPE) 和正常化根平均平方误差 (RMSE) 计算预测性能.
主要成果:
- 包括36名患者 (22名风湿病,14名IBD) 在内.
- 分层分析 (缺乏抗阿达利穆马布抗体) 显示MPE为-2.6%,正常化的RMSE为24.0%.
- 在治疗窗口内预测和测量度之间的一致性为75%.
结论:
- 稳定状态的阿达利穆马布度可以从诱导治疗期间的早期样本中可靠地预测.
- 基于PPK模型的贝叶斯预测为优化阿达利穆马布剂量提供了一个有前途的工具.
- 这种方法可能有助于预防低剂量和改善患有风湿性和炎症性肠道疾病的患者的疾病控制.
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