在新生儿中预测分布体积:基于生理学上的药代动力学建模的性能
Pieter-Jan De Sutter1, Phebe Rossignol1, Lien Breëns1
1Department of Bioanalysis, Ghent University, 9000 Ghent, Belgium.
Pharmaceutics
|September 28, 2023
概括
基于生理学的药理动力学 (PBPK) 模型改善了与传统缩放相比,在新生儿中稳定状态下 (Vss) 药物分布量的预测. 波林和泰尔与贝雷赫科夫斯基校正方法的准确性比罗杰斯和罗兰更好.
科学领域:
- 药理动力学和药物新陈代谢
- 儿科药理学 儿科药理学
- 计算生物学 计算生物学
背景情况:
- 新生儿药物剂量通常依赖于通过异比缩放推断的成年人药动力学参数,这忽略了发育变化.
- 在稳定状态下 (Vss) 准确预测分布体积对于优化新生儿药物治疗至关重要.
- 在新生儿中估计Vss的现有方法可能无法完全考虑生理成熟.
研究的目的:
- 为了比较两个基于生理学的药理动力学 (PBPK) 模型 (Poulin & Theil与Berezhkovskiy校正 (P&T+) 和Rodgers & Rowland (R&R)) 与新生儿Vss的同位尺度缩放的预测精度.
- 评估PBPK方法在预测新生儿群体中一系列药物的Vss中的性能,包括早产婴儿.
主要方法:
- 开发24种药物的PBPK模型,使用in-vitro和in-silico数据.
- 在新生儿群体中模拟Vss使用Simcyp软件.
- 将PBPK预测与86项新生儿研究的临床数据进行比较,使用平均折叠误差 (AFEs) 和绝对平均折叠误差 (AAFEs) 评估准确性.
主要成果:
- 同位尺度缩放低估了新生儿中的Vss (AFE:0.61).
- 这两种PBPK方法都降低了预测不足 (AFE:0.82-0.83),与R&R (AAFE:2.03) 和等比缩放 (AAFE:1.77) 相比,P&T+显示出更高的准确性 (AAFE:1.68).
- 药物特性 (LogP,电离) 和包括早产新生儿并没有显著影响预测错误.
结论:
- 基于生理学上的药理动力学 (PBPK) 建模为预测新生儿Vss提供了更高的准确性,而不是传统的同位尺度缩放.
- 普林和泰尔与贝雷赫科夫斯基校正的PBPK方法证明了对新生儿Vss估计的有希望的适用性.
- PBPK方法为药物开发和新生儿剂量提供了宝贵的工具,特别是在临床数据有限的情况下.
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