药物定位悖论在存在个体内变化的情况下:我们可以估计真正的度-效果关系吗?
Sebastiaan C Goulooze1,2, Elke H J Krekels3,4, Catherijne A J Knibbe4,5
1LAP&P Consultants BV, Archimedesweg 31, 2333 CM, Leiden, The Netherlands. b.goulooze@lapp.nl.
The AAPS journal
|March 27, 2025
概括
药物定位悖论可能会影响暴露-反应 (ER) 建模. 像静态微分方程 (SDE) 或残余误差自相对应等先进的方法成功估计了真实的ER关系,避免了因个体内变化而产生的偏差.
科学领域:
- 药理动力学/药理动力学 (PKPD) 是一个
- 临床药理学 临床药理学
- 生物统计学 生物统计学
背景情况:
- 药物定位悖论发生在较高剂量与较差结果相关时,使暴露-反应 (ER) 关系估计变得复杂.
- 疾病状态的实质性个体内变异性可能会在个人层面上加剧这种悖论,可能会阻止准确的ER建模.
研究的目的:
- 研究不同PKPD建模方法在高个体内变化条件下估计无偏差ER关系时的性能.
- 确定可以在个人层面克服药物定位悖论的建模方法.
主要方法:
- 模拟药物定位研究,包括显著的个体内疾病状态变化.
- 评估了四种PKPD建模技术:标准的个体间变异性 (IIV) 模型,IIV与疾病严重程度的个体间变异性 (IOV),随机差异方程 (SDE) 和残余误差自相关性.
主要成果:
- 标准PKPD模型 (仅IIV,或IIV与IOV根据疾病严重程度) 在ER关系估计中表现出显著的偏差.
- 采用随机微分方程 (SDE) 或将残余误差自相关性考虑的模型成功产生了不偏见的ER关系估计.
结论:
- 准确地描述个体内变异性对于无偏见的PKPD建模至关重要,特别是在定位研究中.
- 在存在药物定位悖论的情况下,先进的方法,如SDE或残余误差自相关性,对于克服混和估计真正的ER关系至关重要.
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