了解使用生理学基础的药物动力学建模来理解他-罗克萨多斯塔特药物-药物-疾病相互作用
Jin Dong1, Luna Prieto Garcia2,3, Yingbo Huang4
1Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland, USA.
Clinical pharmacology and therapeutics
|June 28, 2023
概括
基于生理学的药物动力学建模有助于预测严重慢性病 (CKD) 患者的药物药物疾病相互作用. 这项研究开发了一个虚拟的CKD人群,以评估他类药物与roxadustat的相互作用,指导安全剂量.
科学领域:
- 药理动力学和药物新陈代谢
- 计算机生物学和建模
- 病学和临床药理学
背景情况:
- 药物相互作用 (DDI) 在慢性病 (CKD) 患者中可能因复杂的药物-药物-疾病相互作用 (DDDIs) 而有所不同.
- 基于生理学的药理动力学 (PBPK) 建模为评估DDDI提供了临床试验的有希望的替代方案,但对严重的CKD群体的信心很低,特别是对于非道.
- 需要增强虚拟疾病模型和验证案例,以提高严重的CKD中PBPK预测的准确性.
研究的目的:
- 研究严重的CKD对他类药物的药理动力学 (PK) 和DDI (atorvastatin,simvastatin,rosuvastatin) 的影响.
- 在使用PBPK建模的严重CKD患者中预测他类药物和roxadustat之间的潜在DDI风险.
- 为指导在慢性病患者中与roxadustat同时使用的他类药物的适当剂量方案.
主要方法:
- 开发一种新的虚拟严重的CKD人口模型,考虑脏和非脏通路的影响.
- 构建和四路验证综合药物和疾病PBPK模型.
- 在健康志愿者和慢性病患者中预测他的PK变化,他 - 利番素DDI和他 - 罗沙杜沙特DDI.
主要成果:
- 经验证的PBPK模型准确地预测了改变的他类药物PKs,并在可接受的误差范围内 (1.25至2倍) 恢复已知的DDI.
- 敏感性分析确定肝脏BCRP是罗斯瓦斯丁PK的关键,OATP1B1/3是严重CKD中阿托瓦斯丁PK的关键.
- 在严重的CKD患者中,他类药物-罗沙杜沙特的DDI的幅度预计与健康志愿者的DDI相似.
结论:
- 使用机械虚拟CKD群体的PBPK建模可以在严重CKD中可靠地预测他类PK和DDI.
- 在严重的CKD中,他类固醇的DDI风险与健康个体相似,这表明PBPK导向的剂量可以优化安全性和有效性.
- 开发的PBPK框架为预测DDDI和在复杂患者群体中建立安全剂量策略提供了有价值的工具.
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