经验性剂量策略可以预测怀孕期间的拉莫特里金度
Jessica M Barry1, Jacqueline A French2, Page B Pennell3
1Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
Pharmacotherapy
|July 21, 2023
概括
在怀孕期间使用拉莫特里金维持发作控制是具有挑战性的,因为药理动力学变化. 个性化剂量和治疗药物监测对于在不同患者亚群中平衡发作风险和毒性至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 在怀孕期间,拉莫特里金的药理动力学发生变化,影响了控制.
- 患者亚种群的拉莫特里金清除率各不相同,使剂量复杂化.
- 药物度的改变增加了发作或毒性风险.
研究的目的:
- 评估怀孕期间拉莫特里金的剂量方案.
- 描述增加风险或毒性风险的风险.
- 确定最佳的治疗药物监测策略.
主要方法:
- 将lamotrigine的药理动力学数据应用于一个单间模型.
- 模拟的子群体具有明显的清除变化 (高清除[HC]和低清除[LC]).
- 使用人口模拟 (N=48,000) 用不同的剂量场景和预孕剂量.
主要成果:
- 在没有剂量调整的情况下,度在6-8周内在HC亚群中低于疗效值.
- 没有一个单一的治疗方案能够维持所有女性的治疗度.
- 在某些情景下,模拟预测HC组的风险增加 (7%-100%),LC组的毒性风险增加 (34%-100%).
结论:
- 显著的比例的模拟患者经历了治疗以下或治疗以上的lamotrigine度.
- 早期治疗药物监测可以帮助将患者分类为LC或HC亚群.
- 在怀孕期间,个性化的lamotrigine剂量和监测是必不可少的,避免一种适合所有人的方法.
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