使用生理学基础的药理动力学建模来获得正确的剂量:德克萨米他以防止在儿童中排泄后的斯特里多,作为概念证明
Joyce E M van der Heijden1, Marika de Hoop-Sommen1, Noa Hoevenaars1
1Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands.
基于生理学的药理动力学 (PBPK) 建模可以优化德克萨米他的剂量,用于预防儿科的输出管后肌痛 (PES). 适合年龄的PBPK模型显示,对于婴儿和年龄较大的儿童,需要降低德甲剂量,从而改善药物处置.
科学领域:
- 药理动力学和药物新陈代谢
- 儿科重症监护中心儿童重症监护中心
- 计算建模 计算建模
背景情况:
- 重症儿童的药物处置因年龄,体型和疾病等因素而显著变化.
- 德克萨米他用于预防输出管后 (PES),但需要个性化剂量.
- 在儿童时期,代谢德克萨米他的细胞染色体P450 3A4 (CYP3A4) 酶活性发生了相当大的变化.
研究的目的:
- 为儿童PES预防制定适合年龄的甲剂量建议.
- 证明基于生理学上的药理动力学 (PBPK) 建模对于在重症儿童中个性化药物治疗方案的实用性.
主要方法:
- 使用SimcypTM v21进行了PBPK模拟,使用现有的德克萨米他和儿科人口模型进行了模拟,其中包含CYP3A4本体生成.
- 模型验证是使用已公布的药理动力学 (PK) 数据实现的.
- 模拟目标暴露水平从2-6岁的剂量方案来推断儿童范围内的适龄剂量.
主要成果:
- PBPK模型准确地预测了不同年龄组儿童的德克萨米他血度.
- 剂量建议表明,2-6岁儿童的标准剂量可以用于3个月至2岁的儿童.
- 较小的婴儿 (<3个月) 和较大的儿童 (≥6岁) 建议使用较低的剂量,因为药物代谢和处置的年龄相关差异.
结论:
- PBPK建模是创建基于证据的甲剂量指南的宝贵工具,用于预防儿科PES.
- 婴儿和年龄较大的儿童需要调整德克萨米他的剂量,以考虑到药物处置的变化.
- PBPK建模显示,在重症儿科患者群体中优化药物剂量策略具有前景.
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