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在患有慢性疼痛的儿科患者中,对 gabapentin 和 tramadol 的剂量推理

Paul Healy¹, Luka Verrest¹, Mariagrazia Felisi²

¹Clinical Pharmacology & Therapeutics Group, School of Pharmacy, University College London, London, UK.

Pharmacology research & perspectives

|October 7, 2023

概括

临床试验模拟优化了对儿科慢性疼痛的 gabapentin 和 tramadol 剂量. 确定了剂量策略,以确保儿童的安全和有效的全身暴露.

科学领域:

药理学药理学是指药理学的学科.
儿科医学儿科医学
临床试验设计临床试验设计

背景情况:

加巴丁和特拉马多尔用于治疗儿科慢性疼痛的非标签药物,但它们的疗效和安全性在这个人群中尚不清楚.
对儿童进行慢性疼痛的随机临床试验具有挑战性.

研究的目的:

为未来的临床试验优化剂量和协议设计,研究儿科慢性疼痛患者的 gabapentin 和 tramadol.
描述儿科患者中 gabapentin 和特拉马多尔的药理动力学 (PK).

主要方法:

使用了药理动力学 (PK) 建模和临床试验模拟 (CTS).
系统性暴露 (AUC,Css) 引导剂量选择,假设成人和儿童之间的暴露-反应关系相似.
针对 gabapentin 的剂量,建立了两个重量级别.

主要成果:

确定了从5到63毫克/公斤的 gabapentin 剂量,目标暴露量相当于成人剂量.
2-5毫克/公斤的特拉马多尔剂量达到治疗度,但显示出高的个体间变异性.
模拟场景强调了剂量定位的必要性,以优化治疗范围,并考虑安全性.

结论:

CTS是优化儿科药物研究设计的宝贵工具.
对 gabapentin (t.i.d.) 的推剂量策略和特拉马多尔 (t.i.d.) 的使用. 建议用于儿科慢性疼痛患者.
需要进一步的研究来确认在这个人群中有效性和安全性.

关键词:

剂量合理性的理由超值推算的方法 gabapentin gabapentin 是一个药物.儿科慢性疼痛儿科慢性疼痛药物动力学药物动力学特拉马多尔 (Tramadol) 是一种药物.

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