通过生理学基础的药理动力学建模来描述阿皮克萨班的药理动力学:胆汁分泌和人体肝内循环的关键作用
Toshiaki Tsuchitani1, Wen Kou2, Masatoshi Tomi1
1Faculty of Pharmacy, Keio University, Tokyo, Japan.
CPT: pharmacometrics & systems pharmacology
|December 3, 2025
概括
胆汁分泌和肠肝循环 (EHC) 显著影响人类的阿皮克萨班清除. 这项研究使用了PBPK模型来确认EHC.
科学领域:
- 药理动力学和药物新陈代谢
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿皮克萨班是一种直接口服抗凝剂 (DOAC) 和XA因子抑制剂,主要通过便和尿液排出.
- 以前的理解表明,在人类中,阿皮克萨班的胆汁分泌和肠肝循环 (EHC) 是有限的.
- 活性炭研究表明潜在的EHC参与,促使进一步调查.
研究的目的:
- 量化评估胆道分泌,EHC和肠道分泌对阿皮克萨班药理学 (PK) 的贡献.
- 使用基于生理学的药理动力学 (PBPK) 模型来深入分析阿皮克萨班的处置.
- 为了澄清阿皮克萨班在人类中的排泄途径.
主要方法:
- 开发并验证了使用人类血液度和质量平衡数据的自上而下生理学基础的药业动力学 (PBPK) 模型.
- 使用集群-高斯牛顿方法 (CGNM) 和引导重新抽样优化模型参数.
- 模拟场景,包括EHC的虚拟淘汰和活性炭的联合使用.
主要成果:
- 该PBPK模型准确地描述了观察到的阿皮克萨班PK数据,揭示了相对于代谢清除的中度至高胆道分泌.
- 模拟进入十二指肠的胆汁分泌与人类数据一致 (<2009%的剂量在2009年8小时).
- 虚拟EHC淘汰赛显著缩短了阿皮克萨班半衰期 (2009年8.7至2.9小时),并降低了AUC和便分泌量,证实了EHC的重要作用.
结论:
- 胆汁分泌和肠肝循环 (EHC) 在人类的阿皮克萨班清除和处置中起着重要作用.
- 这些发现挑战了先前对阿皮克萨班有限EHC的假设.
- 建议进行进一步的实验验证,以加强这些药理动力学见解.
相关概念视频
Physiological Pharmacokinetic Models: Incorporating Hepatic Transporter-Mediated Clearance
250
Drug transporters are critical in drug absorption, distribution, and excretion processes. They should be included in physiological-based pharmacokinetic (PBPK) models, which help predict human drug disposition. However, predicting this is challenging during drug development, especially when liver transport is involved. However, with a realistic representation of body transport processes, an accurate model may be possible.
A recent model describes pravastatin's hepatobiliary excretion,...
A recent model describes pravastatin's hepatobiliary excretion,...
250
Model Approaches for Pharmacokinetic Data: Physiological Models
236
Physiological models in pharmacokinetics are instrumental in understanding the distribution and elimination of drugs within the body. These models describe the drug concentration within target organs, influenced by factors such as drug uptake, tissue volume, and blood flow. Drug uptake is governed by the partition coefficient, which signifies the drug concentration ratio in tissue to that in the blood. The blood flow rate to a specific tissue is expressed as Qt, and the rate of change in tissue...
236
Physiological Pharmacokinetic Models: Assumption with Protein Binding
201
Physiological models with protein binding in pharmacokinetics offer a sophisticated approach to understanding drug disposition. These models consider drug-protein interactions, enabling them to effectively predict drug concentrations in different organs and tissues. This precision aids in accurate drug dosing, providing a significant advantage over conventional models. A key process within these models is equilibration, which ensures that drug concentrations achieve a steady state within the...
201
Pharmacokinetic Models: Comparison and Selection Criterion
309
Physiological and compartmental models are valuable tools used in studying biological systems. These models rely on differential equations to maintain mass balance within the system, ensuring an accurate representation of the dynamic processes at play.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
309
Pharmacokinetic Models: Overview
1.8K
Pharmacokinetic models utilize mathematical analysis to achieve a detailed quantitative understanding of a drug's life cycle within the body. They are instrumental in simulating a drug's pharmacokinetic parameters, predicting drug concentrations over time, optimizing dosage regimens, linking concentrations with pharmacologic activity, and estimating potential toxicity.
There are three primary types of models: empirical, compartment, and physiological. Empirical models, with minimal...
There are three primary types of models: empirical, compartment, and physiological. Empirical models, with minimal...
1.8K
Model Approaches for Pharmacokinetic Data: Compartment Models
504
Compartmental analysis is a widely adopted approach to characterizing drug pharmacokinetics. It uses compartment models that conceptualize the body as a collection of reversibly communicating compartments, each representing a group of tissues exhibiting similar drug distribution characteristics. The movement rate of the drug between these compartments is typically described by first-order kinetics.
Two primary types of compartment models are recognized: mammillary and catenary. The more...
Two primary types of compartment models are recognized: mammillary and catenary. The more...
504


