通过Simcyp模拟器预测药物转移到人乳中:来自 ConcePTION项目的贡献
Julia Macente1, Nina Nauwelaerts1, Justine Marine Badée2
1Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
基于生理学的药理动力学 (PBPK) 模型在母乳养安全方面得到了改进. 新的模型准确地预测了牛奶中的药物含量,有助于评估母亲使用药物的婴儿风险.
科学领域:
- 药理动力学和药物新陈代谢
- 孕产妇 - 胎儿 / 婴儿健康
- 计算毒理学计算毒理学
背景情况:
- 基于生理学的药理动力学 (PBPK) 建模有助于决定母婴在哺乳期间使用药物的决定.
- 现有的哺乳期PBPK模型需要增强,以提高预测准确度.
研究的目的:
- 通过整合透性有限的分布和药物特定的清除来增强哺乳期PBPK模型.
- 探索透性与 perfusion-limited分布模型在药物分发到母乳中的实用性.
- 开发一个决策树,以选择适合的哺乳期PBPK的分布模型.
主要方法:
- 根据临床数据开发并验证了参考PBPK模型 (GMFE 1.13-1.51,AFE 0.68-1.42).
- 扩展经过验证的模型用于哺乳期PBPK,使用透性或 perfusion-limited假设.
- 纳入药物特定的双向内在清除,用于透性有限的模型.
- 应用模型来预测使用Simcyp模拟器对11种药物的母乳药物度和相对婴儿剂量 (RID).
主要成果:
- 哺乳期PBPK模型准确地预测了血药业动力学,母乳度和牛奶与血的比率.
- 在11种药物中,有9种药物的RID低于25%的安全值.
- 列维和尼维拉平的RID相对较高 (高达21%).
结论:
- 增强的哺乳期PBPK模型,包括透性有限的分布和特定清除,显示出强大的预测性能.
- 拟议的决策树有助于为未来的哺乳期PBPK应用选择合适的分布模型.
- 开发的工作流程支持更广泛的婴儿风险评估,用于哺乳期间母亲的药物治疗.
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