在临床试验期间同时进行剂量修改的情况下,终点暴露-反应分析
Rui Zhong1,2, Yanguang Cao1
1Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Clinical pharmacology and therapeutics
|November 26, 2025
概括
由于不良事件 (AE) 的剂量修改,传统的暴露-反应分析可能会误导. 为AE驱动的剂量修改进行调整可以提高准确性,这对于可靠的药物开发和剂量选择至关重要.
科学领域:
- 制药指标 (Pharmacometrics) 是一个指标.
- 药物开发 药物开发
- 临床药理学 临床药理学
背景情况:
- 暴露-反应 (ER) 分析对于药物剂量选择至关重要.
- 传统的ER方法往往忽略了由不良事件 (AE) 引起的剂量修改 (DMs),可能会导致结果偏差.
- 了解AE驱动的DM对ER关系的影响对于准确的药物评估至关重要.
研究的目的:
- 开发一个框架来量化AE驱动的DM对ER关系的影响.
- 探索在DMs的存在下提高ER分析准确性的策略.
- 为了评估E-R关系,考虑计划和实际的剂量暴露.
主要方法:
- 作为一个案例研究,使用了杜维利西布 (duvelisib),一种经常出现DM的药物.
- 我们比较了三种E-R场景:地面真相,常规 (计划暴露) 和经DM调整 (实际暴露).
- 评估了AE发病时间和DMs对ER关系准确性的影响.
主要成果:
- 传统的ER分析显著偏离了基本的真相,经常出现DM,特别是在延迟的AE.
- 早期出现的AE和随后的DM扭曲了以后AE的ER关系.
- 经DM调整的ER分析提高了晚期AE的准确性,但对早期AE存在过度校正的风险.
结论:
- 将AE时间和DM纳入E-R分析对于强大的药物开发至关重要.
- 准确解释ER关系需要考虑现实世界的临床事件,如DMs.
- 这一框架提高了药物剂量选择的可靠性,药物剂量经常受到AE驱动的修改.
相关概念视频
Dose-Response Relationship: Overview
4.7K
Agonists can bind with and activate receptors, resulting in the formation of drug-receptor complexes. Once formed, these complexes catalyze many biochemical processes at the cellular level and subsequently induce a pharmacologic response. The degree of response is directly proportional to the fraction of activated receptors, which in turn, depends on the concentration of the drug at the receptor site as well as the sensitivity of the receptor. An increase in the administered dose contributes to...
4.7K
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
387
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
387
Dose-Response Relationship: Potency and Efficacy
6.3K
The potency of a drug is the measure of its ability to produce a biological response and can be compared by looking at the half-maximum effective concentration or EC50 values of different drugs. A lower EC50 value indicates higher potency of the drug. In the dose–response curve of two antihypertensive drugs, candesartan and irbesartan, a significant difference is observed in their EC50 values. A lower EC50 value for candesartan indicates that it is more potent than irbesartan, as it...
6.3K
Dosage Regimens: Designs and Approaches
246
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
246
Dose Size and Dosing Frequency: Determination Methods
260
Determining the optimal dose size and dosing frequency in pharmacotherapy is crucial for achieving therapeutic effectiveness while minimizing adverse effects. This article explores the methodologies employed in determining these parameters, focusing on their significance and interplay to tailor dosing regimens.Dose Size: Dose size refers to the amount of a drug administered in a single dose. It is determined based on the drug's pharmacodynamics and pharmacokinetics properties and...
260
Bioavailability Study Design: Single Versus Multiple Dose Studies
189
Bioavailability studies are essential for understanding how a drug is absorbed, distributed, metabolized, and excreted in the body. These studies assess the extent and rate at which the active pharmaceutical agent becomes available at the site of action. The design of bioavailability studies can involve single-dose or multiple-dose regimens, each with distinct advantages and limitations.Single-dose studies are the preferred approach due to their simplicity and reduced drug exposure for...
189


