在患有急性移植与宿主疾病的儿科患者中,基于模型的阿巴cept剂量建议
Rui Zhong1,2, Kelly Maxwell3, Julie Passarell3
1Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Journal of clinical pharmacology
|February 13, 2026
概括
这项研究建议为2至6岁的儿科患者服用15毫克/千克的加载剂量,然后为12毫克/千克的维持剂量服用阿巴切,这些患者接受了血液生成干细胞移植,以预防急性移植对宿主疾病 (aGVHD). 这种方案确保了安全和有效的阿巴cept暴露.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 儿科血液学 儿科血液学
- 免疫学 免疫学 免疫学
背景情况:
- 急性移植对宿主疾病 (aGVHD) 是血液造血干细胞移植 (HSCT) 后的一种严重并发症.
- 阿巴塞普特用于aGVHD预防,但在年轻儿科患者中最佳剂量需要定义.
- 血液性恶性瘤 (HM) 是儿童群体中HSCT的常见症状.
研究的目的:
- 在儿科患者中建立阿巴塔塞普特的人口药理学 (PPK) 模型.
- 为了确定2至6岁的儿童的最佳阿巴特阿塞普特剂量方案,这些儿童接受HSCT用于HM,以预防aGVHD.
- 评估阿巴特切普特暴露在这个脆弱人群中的安全性.
主要方法:
- 开发并改进了一种中间PPK模型,使用了904名患有青少年异常性关节炎的儿科患者 (2-17岁) 的数据.
- 在各种剂量场景下,对虚拟儿科患者 (2至<6岁) 用最终的PPK模型进行了PK模拟.
- 在接受HSCT的6岁以上的患者中进行了暴露-反应 (E-R) 安全分析.
主要成果:
- 最终的PPK模型使用线性,两部分模型对 abatacept 暴露进行了表征,该模型的参数估计与之前的研究相比较.
- 模拟表明,在虚拟儿科患者 (2至6岁以下) 中,15mg/kg的加载剂量,然后是12mg/kg的维持剂量,可以达到与成人相似的暴露水平.
- 在E-R安全性分析中,在老儿HSCT患者中,阿巴塔cept暴露和感染发生之间没有显著的关联.
结论:
- 建议在第1天给出15mg/kg的负载剂量,然后在第5天,第14天和第28天给出12mg/kg的推剂量方案,用于患有aGVHD风险的2至6岁的儿科患者.
- 预计这种治疗方案将在这个年龄组中为aGVHD预防提供安全和有效的阿巴特塞普暴露.
- 这项研究证实了阿巴塔塞普特在儿科HSCT患者感染风险方面的安全性.
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