在肝脏和/或脏功能障碍患者中对聚米辛B的种群药动力学模型进行系统评估
Xueyong Li1,2, Yu Cheng1, Bingqing Zhang1,2
1Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China.
已建立的聚米辛B (PMB) 种群药动力学 (PopPK) 模型缺乏外部预测能力,特别是在器官功能障碍患者中. 贝叶斯预测显示,通过先前的数据来提高PMB剂量准确度是有前途的.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 临床药房 临床药房
背景情况:
- 聚米辛B (PMB) 是一种关键的最后一线抗生素,用于治疗多药耐药性 (MDR) 格拉姆阴性感染.
- 人口药理动力学 (PopPK) 模型旨在优化PMB剂量以改善患者的治疗结果.
- 现有PMB PopPK模型的外部预测性能需要进行彻底的评估.
研究的目的:
- 通过独立的患者队列系统评估11个已发表的PMB PopPK模型.
- 评估不同患者子组的模型可预测性:正常功能,肝功能障碍,功能障碍和综合功能障碍.
- 调查贝叶斯预测对提高PMB剂量预测的有用性.
主要方法:
- 对11个PMB PopPK模型与146名患者 (391个度) 的数据集进行外部验证.
- 在四个不同的患者群体中对模型性能进行了分层分析.
- 应用基于预测和模拟的诊断和贝叶斯预测,用于模型评估.
主要成果:
- 没有一个单一的模型在整个预测和模拟诊断中显示出令人满意的预测能力.
- 模型显示,与功能障碍患者相比,肝脏和功能正常的患者的预测性能更好.
- 贝叶斯预测提高了可预测性,特别是在结合两到三次先前的观察时.
结论:
- 现有的PMB PopPK模型表现出有限的外部预测一致性,特别是在肝脏或功能障碍患者中.
- 贝叶斯预测提供了一种可行的策略,可以提高PMB剂量模型的预测准确性.
- 治疗药物监测对于完善个人PMB剂量方案至关重要.
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