STRATIfy-PK SCORE:用于识别抗TNF治疗患者的药理学失败风险的预测工具
Carles Iniesta-Navalón1,2,3, Manuel Ríos-Saorín1,2, Lorena Rentero-Redondo1,2
1Department of Hospital Pharmacy, Reina Sofia Hospital of Murcia, Murcia, Spain.
British journal of clinical pharmacology
|November 21, 2025
概括
鉴定因弗利西马布和阿达利穆马布治疗中药动力学失败的危险因素至关重要. STRATIfy-PK SCORE有助于早期检测有风险的患者,从而能够进行主动的治疗药物监测,以获得更好的结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 免疫学 免疫学 免疫学
- 临床药房 临床药房
背景情况:
- 药物动力学 (PK) 失效,包括免疫性和亚治疗性药物度,影响了诸如因弗利西马布 (IFX) 和阿达利马布 (ADA) 等生物药物的治疗疗效.
- 识别患有PK衰竭风险的患者对于优化治疗药物监测 (TDM) 策略至关重要.
- 预测模型可以增强免疫媒介炎症疾病 (IMIDs) 的生物疗法的个性化.
研究的目的:
- 在接受IFX或ADA的患者中识别药理学失败的风险因素.
- 开发一种预测模型,即 STRATIfy-PK SCORE,用于早期识别患有 PK 失败风险的患者.
- 支持主动和个性化的治疗药物监测 (TDM) 战略.
主要方法:
- 以IFX或ADA治疗的IMID成年患者的回顾性队列研究.
- 通过抗药抗体或亚治疗性血清度定义的药物动力学失效.
- 开发了多变量逻辑回归模型,通过AUC和校准图表评估性能.
主要成果:
- 在59.7%的患者中观察到亚治疗度,在18.8%的患者中观察到免疫性.
- 确定了IFX和ADA的免疫性和亚治疗度的特定预测因子.
- 开发了具有良好的区分性能 (AUC 0.686-0.800) 的预测模型.
结论:
- STRATIfy-PK SCORE有效地识别了高危药理学失败的患者.
- 这一分数可以促进主动的,个性化的TDM策略.
- 优化的TDM有可能改善IFX和ADA治疗患者的临床结果.
相关概念视频
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
170
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
170
Nonlinear Pharmacokinetics: Overview
1.0K
Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
Nonlinearity can arise due to the saturation of plasma protein-binding or...
Nonlinearity can arise due to the saturation of plasma protein-binding or...
1.0K
Analysis of Population Pharmacokinetic Data
659
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
659
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
199
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
199
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
204
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
204
Dosage Regimens: Partial Pharmacokinetic Parameters
138
It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
138

