在怀孕期间优化venlafaxine治疗:一种母胎PBPK建模方法
Seo-Yeon Choi1, Eunsol Yang2, Kwang-Hee Shin1,3
1College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea.
一个新的基于生理学的药理动力学模型有助于优化怀孕期间的拉法辛剂量. 建议每天服用150毫克剂量,以平衡孕产妇和胎儿的安全性和疗效.
科学领域:
- 药理动力学和药物新陈代谢
- 生殖毒理学 生殖毒理学
- 计算生物学 计算生物学
背景情况:
- 怀孕显著改变药物的药理动力学,影响文拉法辛及其活性代谢物O-desmethylvenlafaxine (ODV) 的水平.
- 现有的研究缺乏生理学基础的药理动力学 (PBPK) 模型,用于怀孕期间同时使用venlafaxine和ODV.
- 了解这些变化对于安全有效的母亲抗抑郁药治疗至关重要.
研究的目的:
- 在孕妇中开发和验证venlafaxine和ODV的PBPK模型.
- 预测母亲和胎儿在整个怀孕期间暴露于文拉法辛和ODV.
- 为了优化孕妇的文拉法辛剂量方案.
主要方法:
- 使用Simcyp模拟器为非孕妇和孕妇开发了venlafaxine和ODV的PBPK模型,包括胎儿-胎盘单元.
- 使用视觉预测检查验证模型性能,并比较预测与观察到的Cmax和AUC比率 (0.7-1.3).
主要成果:
- 该PBPK模型准确地预测了非怀孕妇女的文拉法辛和ODV度.
- 对于孕妇的预测一般都在95%的置信区间内,随着怀孕的进展,药物度下降.
- 带与母体度比率接近1.0,但较高的剂量接近胎儿毒性值.
结论:
- 建议孕妇服用150毫克/天的文拉法辛剂量.
- 这一剂量旨在保持治疗疗效,同时最大限度地降低对母亲和胎儿的毒性风险.
- 需要对更大的样本大小进行进一步的研究,才能提出最终的建议.
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