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Genetic variation present in the CYP3A4 gene in Ni-Vanuatu and Kenyan populations in malaria endemicity 疟疾流行地区尼-瓦努阿图和肯尼亚人口中 CYP3A4 基因的遗传变异
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-01 DOI: 10.1016/j.dmpk.2024.101029
Kelvin Musyoka , Chim W. Chan , Evelyn Marie Gutiérrez Rico , Protus Omondi , Caroline Kijogi , Takatsugu Okai , James Kongere , Mtakai Ngara , Wataru Kagaya , Bernard N. Kanoi , Masahiro Hiratsuka , Yasutoshi Kido , Jesse Gitaka , Akira Kaneko

Cytochrome P450 3A4 (CYP3A4) enzyme is involved in the metabolism of about 30 % of clinically used drugs, including the antimalarials artemether and lumefantrine. CYP3A4 polymorphisms yield enzymatic variants that contribute to inter-individual variation in drug metabolism. Here, we examined CYP3A4 polymorphisms in populations from malaria-endemic islands in Lake Victoria, Kenya, and Vanuatu, to expand on the limited data sets. We used archived dried blood spots collected from 142 Kenyan and 263 ni-Vanuatu adults during cross-sectional malaria surveys in 2013 and 2005–13, respectively, to detect CYP3A4 variation by polymerase chain reaction (PCR) and sequencing. In Kenya, we identified 14 CYP3A4 single nucleotide polymorphisms (SNPs), including the 4713G (CYP3A4∗1B; allele frequency 83.9 %) and 19382A (CYP3A4∗15; 0.7 %) variants that were previously linked to altered metabolism of antimalarials. In Vanuatu, we detected 15 SNPs, including the 4713A (CYP3A4∗1A; 88.6 %) and 25183C (CYP3A4∗18; 0.6 %) variants. Additionally, we detected a rare and novel SNP C4614T (0.8 %) in the 5′ untranslated region. A higher proportion of CYP3A4 genetic variance was found among ni-Vanuatu populations (16 %) than among Lake Victoria Kenyan populations (8 %). Our work augments the scarce data sets and contributes to improved precision medicine approaches, particularly to anti-malarial chemotherapy, in East African and Pacific Islander populations.

细胞色素 P450 3A4 (CYP3A4) 酶参与了约 30% 临床常用药物的代谢,其中包括抗疟药物蒿甲醚和鲁米芬特林。CYP3A4 多态性产生的酶变异可导致药物代谢的个体间差异。在此,我们研究了维多利亚湖、肯尼亚和瓦努阿图疟疾流行岛屿人群的 CYP3A4 多态性,以扩展有限的数据集。我们利用分别于 2013 年和 2005-13 年在疟疾横断面调查中收集的 142 名肯尼亚成年人和 263 名瓦努阿图成年人的存档干血斑,通过聚合酶链式反应(PCR)和测序检测 CYP3A4 的变异。在肯尼亚,我们发现了 14 个 CYP3A4 单核苷酸多态性 (SNP),包括 4713G(CYP3A4∗1B;等位基因频率 83.9 %)和 19382A(CYP3A4∗15;0.7 %)变异,这些变异以前与抗疟药代谢的改变有关。在瓦努阿图,我们检测到 15 个 SNPs,包括 4713A(CYP3A4∗1A;88.6%)和 25183C(CYP3A4∗18;0.6%)变异。此外,我们还在 5′ 非翻译区检测到一个罕见的新型 SNP C4614T(0.8%)。在尼-瓦努阿图人群中发现的 CYP3A4 遗传变异比例(16%)高于维多利亚湖肯尼亚人群(8%)。我们的工作扩充了稀缺的数据集,有助于改进东非和太平洋岛民的精准医疗方法,特别是抗疟疾化疗方法。
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引用次数: 0
Physiologically based pharmacokinetic modeling of CYP2C8 substrate rosiglitazone and its metabolite to predict metabolic drug-drug interaction 基于生理学的 CYP2C8 底物罗格列酮及其代谢物的药代动力学模型,以预测代谢药物与药物之间的相互作用。
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-01 DOI: 10.1016/j.dmpk.2024.101023
Nilesh Gaud , Dawid Gogola , Anna Kowal-Chwast , Ewelina Gabor-Worwa , Peter Littlewood , Krzysztof Brzózka , Kamil Kus , Maria Walczak

Rosiglitazone is an activator of nuclear peroxisome proliferator-activated (PPAR) receptor gamma used in the treatment of type 2 diabetes mellitus. The elimination of rosiglitazone occurs mainly via metabolism, with major contribution by enzyme cytochrome P450 (CYP) 2C8. Primary routes of rosiglitazone metabolism are N-demethylation and hydroxylation. Modulation of CYP2C8 activity by co-administered drugs lead to prominent changes in the exposure of rosiglitazone and its metabolites. Here, we attempt to develop mechanistic parent-metabolite physiologically based pharmacokinetic (PBPK) model for rosiglitazone. Our goal is to predict potential drug-drug interaction (DDI) and consequent changes in metabolite N-desmethyl rosiglitazone exposure. The PBPK modeling was performed in the PKSim® software using clinical pharmacokinetics data from literature. The contribution to N-desmethyl rosiglitazone formation by CYP2C8 was delineated using vitro metabolite formation rates from recombinant enzyme system. Developed model was verified for prediction of rosiglitazone DDI potential and its metabolite exposure based on observed clinical DDI studies. Developed model exhibited good predictive performance both for rosiglitazone and N-desmethyl rosiglitazone respectively, evaluated based on commonly acceptable criteria. In conclusion, developed model helps with prediction of CYP2C8 DDI using rosiglitazone as a substrate, as well as changes in metabolite exposure. In vitro data for metabolite formation can be successfully utilized to translate to in vivo conditions.

罗格列酮是一种核过氧化物酶体增殖激活(PPAR)受体γ的激活剂,用于治疗2型糖尿病。罗格列酮主要通过新陈代谢排出体外,其中细胞色素 P450 (CYP) 2C8 酶的作用最为重要。罗格列酮的主要代谢途径是 N-去甲基化和羟基化。合用药物对 CYP2C8 活性的调节会导致罗格列酮及其代谢物的暴露量发生显著变化。在此,我们尝试为罗格列酮开发基于生理学药代动力学(PBPK)的母体-代谢物机理模型。我们的目标是预测潜在的药物相互作用(DDI)以及代谢物 N-去甲基罗格列酮暴露量的相应变化。利用文献中的临床药代动力学数据,在 PKSim® 软件中进行了 PBPK 建模。利用重组酶系统的体外代谢物形成率,划定了 CYP2C8 对 N-去甲基罗格列酮形成的贡献。根据观察到的临床 DDI 研究结果,验证了所开发的模型可用于预测罗格列酮的 DDI 潜力及其代谢物暴露。根据普遍接受的标准进行评估,所开发的模型对罗格列酮和 N-去甲基罗格列酮分别表现出良好的预测性能。总之,所开发的模型有助于预测以罗格列酮为底物的 CYP2C8 DDI 以及代谢物暴露的变化。代谢物形成的体外数据可成功用于体内条件。
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引用次数: 0
Iminium ion metabolites are formed from nintedanib by human CYP3A4 人类 CYP3A4 可从 nintedanib 生成氨离子代谢物
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-01 DOI: 10.1016/j.dmpk.2024.101025

Nintedanib is used to treat idiopathic pulmonary fibrosis, systemic sclerosis, interstitial lung disease, and progressive fibrotic interstitial lung disease. It is primarily cleared via hepatic metabolism, hydrolysis, and glucuronidation. In addition, formation of the iminium ion, a possible reactive metabolite, was predicted based on the chemical structure of nintedanib. To obtain a hint which may help to clarify the cause of nintedanib-induced liver injury, we investigated whether iminium ions were formed in the human liver. To detect unstable iminium ions using liquid chromatography-tandem mass spectrometry (LC-MS/MS), potassium cyanide was added to the reaction mixture as a trapping agent. Human liver and intestinal microsomes were incubated with nintedanib in the presence of NADPH to form two iminium ion metabolites on the piperazine ring. Their formation is strongly inhibited by ketoconazole, a potent cytochrome P450 (CYP) 3A4 inhibitor. Among the recombinant P450s, only CYP3A4 formed cyanide adducts. The role of CYP3A4 was supported by the positive correlation between CYP3A4 protein abundance, as determined by LC-MS-based proteomics, and the formation of cyanide adducts in 25 individual human liver microsomes. In conclusion, we have demonstrated that iminium ion metabolites are formed from nintedanib by CYP3A4 as potential reactive metabolites.

Nintedanib 用于治疗特发性肺纤维化、系统性硬化症、间质性肺病和进行性纤维化间质性肺病。它主要通过肝脏代谢、水解和葡萄糖醛酸化清除。此外,根据宁替达尼的化学结构,还预测了亚氨基离子(一种可能的活性代谢物)的形成。为了获得有助于阐明宁替尼致肝损伤原因的提示,我们研究了亚氨基离子是否在人体肝脏中形成。为了使用液相色谱-串联质谱(LC-MS/MS)检测不稳定的亚氨基离子,我们在反应混合物中加入了氰化钾作为捕获剂。在 NADPH 存在下,将人肝脏和肠道微粒体与宁替丹尼培养,在哌嗪环上形成两种亚氨离子代谢物。细胞色素 P450 (CYP) 3A4 强效抑制剂酮康唑会强烈抑制它们的形成。在重组 P450s 中,只有 CYP3A4 会形成氰化物加合物。通过 LC-MS 蛋白质组学测定的 CYP3A4 蛋白丰度与 25 个人体肝脏微粒体中氰化物加合物的形成之间存在正相关,这证明了 CYP3A4 的作用。总之,我们已经证明,CYP3A4 会使宁替尼形成亚氨离子代谢物,并使其成为潜在的反应性代谢物。
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引用次数: 0
Human brain organoids for understanding substance use disorders 了解药物使用障碍的人脑器官模型
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-26 DOI: 10.1016/j.dmpk.2024.101031

Substance use disorders (SUDs) are complex mental health conditions involving a problematic pattern of substance use. Challenges remain in understanding their neural mechanisms, which are likely to lead to improved SUD treatments. Human brain organoids, brain-like 3D in vitro cultures derived from human stem cells, show unique potential in recapitulating the response of a developing human brain to substances. Here, we review the recent progress in understanding SUDs using human brain organoid models focusing on neurodevelopmental perspectives. We first summarize the background of SUDs in humans. Moreover, we introduce the development of various human brain organoid models and then discuss current progress and findings underlying the abuse of substances like nicotine, alcohol, and other addictive drugs using organoid models. Furthermore, we review efforts to develop organ chips and microphysiological systems to engineer better human brain organoids for advancing SUD studies. Lastly, we conclude by elaborating on the current challenges and future directions of SUD studies using human brain organoids.

物质使用障碍(SUD)是一种复杂的精神疾病,涉及有问题的物质使用模式。在了解其神经机制方面仍然存在挑战,而了解这些机制很可能有助于改进药物使用障碍的治疗。人脑器官组织是由人类干细胞衍生的类脑三维体外培养物,在重现发育中的人脑对药物的反应方面显示出独特的潜力。在此,我们从神经发育的角度回顾了利用人脑类器官模型了解 SUD 的最新进展。我们首先总结了人类 SUD 的背景。此外,我们还介绍了各种人脑类器官模型的发展,然后讨论了目前利用类器官模型研究尼古丁、酒精和其他成瘾药物滥用的进展和发现。此外,我们还回顾了开发器官芯片和微生理系统的工作,以设计出更好的人脑类器官,推动 SUD 研究。最后,我们阐述了使用人脑器官模型进行 SUD 研究的当前挑战和未来方向。
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引用次数: 0
Clinical pharmacokinetic characteristics of Jaktinib in subjects with hepatic impairment in a phase I trial I期试验中Jaktinib在肝功能受损受试者中的临床药代动力学特征
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-20 DOI: 10.1016/j.dmpk.2024.101030
Manna Zhao , Hua Zhang , Sheng Ma , Shuqing Gong , Cheng Wei , Liyan Miao , Weifeng Zhao
Jaktinib is a novel Janus kinase (JAK) inhibitor, and a phase I clinical trial of single-dose Jaktinib was conducted in a population of subjects with hepatic impairment to assess the safety, tolerability, and pharmacokinetic characteristics of Jaktinib. The patients were administered orally with 100 mg Jaktinib on day 1 in all the mild hepatic impairment group (mild group, n = 8), moderate hepatic impairment group (moderate group, n = 8) and normal hepatic function group (normal group, n = 8), and the blood samples were collected for later analysis. The mild to moderate hepatic impairment affected the metabolism of Jaktinib, which may lead to accumulation of original Jaktinib. The pharmacokinetic characteristics of the metabolites (ZG0244 and ZG0245) of Jaktinib were also analyzed. The exposure of Jaktinib is approximately 2-fold in patients with mild and moderate hepatic impairment than normal hepatic function. No serious adverse events occurred. In summary, a dosage reduction is recommended for patients with mild or moderate hepatic impairment. Further investigations for the dose adjustment in mild/moderate hepatic impairment will be considered. Trial registration number: NCT04993404.
Jaktinib是一种新型Janus激酶(JAK)抑制剂,在肝功能受损的受试者中开展了单剂量Jaktinib的I期临床试验,以评估Jaktinib的安全性、耐受性和药代动力学特征。所有轻度肝功能损害组(轻度组,n = 8)、中度肝功能损害组(中度组,n = 8)和肝功能正常组(正常组,n = 8)的患者均在第1天口服100毫克Jaktinib,并采集血样进行后期分析。轻度至中度肝功能损害影响了Jaktinib的代谢,可能导致原始Jaktinib的蓄积。研究还分析了Jaktinib代谢物(ZG0244和ZG0245)的药代动力学特征。轻度和中度肝功能损害患者的Jaktinib暴露量约为正常肝功能患者的2倍。未发生严重不良事件。总之,建议轻度或中度肝功能损害患者减少用药剂量。将考虑进一步研究轻度/中度肝功能损害患者的剂量调整问题。试验注册号:NCT04993404:NCT04993404。
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引用次数: 0
Characteristics of membrane transport, metabolism, and target protein binding of cyclic depsipeptide destruxin E in HeLa cells 环去肽去甲芦荟素 E 在 HeLa 细胞中的膜转运、代谢和靶蛋白结合特性
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-02 DOI: 10.1016/j.dmpk.2024.101028
Makoto Amifuji , Mai Inagaki , Masahito Yoshida , Takayuki Doi , Masanori Tachikawa

Cyclic peptides have attracted attention as new modalities for drug development owing to their unique pharmacokinetic and pharmacodynamic properties. Destruxin E, a 19-membered cyclodepsipeptide, is a promising candidate drug for cancer therapy. The purpose of the present study was to clarify the molecular mechanisms underlying membrane transport, metabolism, and the binding for target molecules of destruxin E in human cervical carcinoma HeLa cells used as a model of cancer cells. The influx transport and the intracellular metabolism of destruxin E were non-saturable and saturable, respectively, at up to 10 μM. The intracellular amounts of destruxin E and destruxin E-diol after incubation of destruxin E with the cells significantly decreased at 4 °C compared to those at 37 °C. Destruxin E-diol, but not destruxin E, undergoes efflux transport out of cells via P-gp/MDR1/ABCB1 and BCRP/ABCG2. The epoxide hydrolase EPHX2 functions as a potent metabolizing enzyme that can convert the epoxide of destruxin E to the destruxin E-diol. Treatment with an EPHX2 inhibitor increased the intracellular destruxin E levels and enhanced the inhibitory activity of vacuolar type-H+ ATPase. These results suggest that epoxide hydrolase could be a regulatory factor for intracellular destruxin E levels and its pharmacological activity.

环肽因其独特的药代动力学和药效学特性,作为药物开发的新模式备受关注。Destruxin E 是一种 19 元环十二肽,是一种很有前途的癌症治疗候选药物。本研究旨在阐明 destruxin E 在作为癌细胞模型的人宫颈癌 HeLa 细胞中的膜转运、代谢以及与靶分子结合的分子机制。在 10 μM 以下,去铁素 E 的流入转运和细胞内代谢分别是不可饱和和可饱和的。去铁素 E 与细胞培养后,细胞内去铁素 E 和去铁素 E-二醇的含量在 4 ℃ 时比 37 ℃ 时明显减少。destruxin E-diol(而非 destruxin E)可通过 P-gp/MDR1/ABCB1 和 BCRP/ABCG2 从细胞中外流。环氧化物水解酶 EPHX2 是一种有效的代谢酶,可将去铁素 E 的环氧化物转化为去铁素 E-二醇。使用 EPHX2 抑制剂会增加细胞内去铁素 E 的含量,并增强空泡型-H+ ATPase 的抑制活性。这些结果表明,环氧化物水解酶可能是细胞内去铁素 E 含量及其药理活性的一个调节因素。
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引用次数: 0
Preface: In silico technologies to facilitate drug development 前言促进药物开发的硅学技术
IF 2.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-01 DOI: 10.1016/j.dmpk.2024.101022
Kazuya Maeda Ph.D., Masayo Oishi Ph.D.
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引用次数: 0
Beyond the basics: A deep dive into parameter estimation for advanced PBPK and QSP models 超越基础:深入了解高级 PBPK 和 QSP 模型的参数估计
IF 2.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-01 DOI: 10.1016/j.dmpk.2024.101011
Kota Toshimoto

Physiologically-based pharmacokinetic (PBPK) models and quantitative systems pharmacology (QSP) models have contributed to drug development strategies. The parameters of these models are commonly estimated by capturing observed values using the nonlinear least-squares method. Software packages for PBPK and QSP modeling provide a range of parameter estimation algorithms. To choose the most appropriate method, modelers need to understand the basic concept of each approach. This review provides a general introduction to the key points of parameter estimation with a focus on the PBPK and QSP models, and the respective parameter estimation algorithms. The latter part assesses the performance of five parameter estimation algorithms – the quasi-Newton method, Nelder-Mead method, genetic algorithm, particle swarm optimization, and Cluster Gauss-Newton method – using three examples of PBPK and QSP modeling. The assessment revealed that some parameter estimation results were significantly influenced by the initial values. Moreover, the choice of algorithms demonstrating good estimation results heavily depends on factors such as model structure and the parameters to be estimated. To obtain credible parameter estimation results, it is advisable to conduct multiple rounds of parameter estimation under different conditions, employing various estimation algorithms.

基于生理的药代动力学(PBPK)模型和定量系统药理学(QSP)模型为药物开发战略做出了贡献。这些模型的参数通常是通过使用非线性最小二乘法获取观察值来估算的。用于 PBPK 和 QSP 模型的软件包提供了一系列参数估计算法。要选择最合适的方法,建模者需要了解每种方法的基本概念。本综述概括介绍了参数估计的要点,重点是 PBPK 和 QSP 模型以及各自的参数估计算法。后一部分以三个 PBPK 和 QSP 模型为例,评估了准牛顿法、Nelder-Mead 法、遗传算法、粒子群优化和集群高斯-牛顿法这五种参数估计算法的性能。评估结果表明,一些参数估计结果受初始值的影响很大。此外,选择哪种算法能显示出良好的估算结果在很大程度上取决于模型结构和待估算参数等因素。为了获得可靠的参数估计结果,最好在不同条件下采用不同的估计算法进行多轮参数估计。
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引用次数: 0
DMPK perspective on quantitative model analysis for chimeric antigen receptor cell therapy: Advances and challenges 从 DMPK 角度看嵌合抗原受体细胞疗法的定量模型分析:进展与挑战
IF 2.1 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-06-01 DOI: 10.1016/j.dmpk.2024.101003
Akihiko Goto, Yuu Moriya, Miyu Nakayama, Shinji Iwasaki, Syunsuke Yamamoto

Chimeric antigen receptor (CAR) cells are genetically engineered immune cells that specifically target tumor-associated antigens and have revolutionized cancer treatment, particularly in hematological malignancies, with ongoing investigations into their potential applications in solid tumors. This review provides a comprehensive overview of the current status and challenges in drug metabolism and pharmacokinetics (DMPK) for CAR cell therapy, specifically emphasizing on quantitative modeling and simulation (M&S). Furthermore, the recent advances in quantitative model analysis have been reviewed, ranging from clinical data characterization to mechanism-based modeling that connects in vitro and in vivo nonclinical and clinical study data. Additionally, the future perspectives and areas for improvement in CAR cell therapy translation have been reviewed. This includes using formulation quality considerations, characterization of appropriate animal models, refinement of in vitro models for bottom-up approaches, and enhancement of quantitative bioanalytical methodology. Addressing these challenges within a DMPK framework is pivotal in facilitating the translation of CAR cell therapy, ultimately enhancing the patients’ lives through efficient CAR cell therapies.

嵌合抗原受体(CAR)细胞是一种基因工程免疫细胞,可特异性靶向肿瘤相关抗原,为癌症治疗,尤其是血液恶性肿瘤的治疗带来了革命性的变化,目前正在研究其在实体瘤中的潜在应用。本综述全面概述了 CAR 细胞疗法药物代谢和药代动力学 (DMPK) 的现状和挑战,特别强调了定量建模和模拟 (M&S)。此外,还回顾了定量模型分析的最新进展,从临床数据特征描述到连接体外和体内非临床和临床研究数据的基于机理的建模。此外,还回顾了 CAR 细胞疗法转化的未来前景和有待改进的领域。这包括使用制剂质量考虑因素、适当动物模型的特征描述、完善自下而上方法的体外模型,以及加强定量生物分析方法。在 DMPK 框架内应对这些挑战对于促进 CAR 细胞疗法的转化至关重要,最终将通过高效的 CAR 细胞疗法改善患者的生活。
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引用次数: 0
Population pharmacokinetic analysis of sirolimus in Japanese pediatric and adult subjects receiving tablet or granule formulations 西罗莫司在接受片剂或颗粒剂治疗的日本儿童和成人受试者中的群体药代动力学分析。
IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pub Date : 2024-05-31 DOI: 10.1016/j.dmpk.2024.101024
Taichi Miyazaki , Daichi Hayashi , Akifumi Nozawa , Shiho Yasue , Saori Endo , Hidenori Ohnishi , Ryuta Asada , Mototoshi Kato , Akihiro Fujino , Tatsuo Kuroda , Takanobu Maekawa , Shigehisa Fumino , Naonori Kawakubo , Tatsuro Tajiri , Kenji Shimizu , Chihiro Sanada , Izumi Hamada , Yuko Ishikawa , Mayumi Hasegawa , Kashyap Patel , Michio Ozeki
A population pharmacokinetic (PopPK) analysis was conducted using data from 215 Japanese administered oral sirolimus (tablet and granule) including healthy subjects and patients with intractable vascular anomalies and other diseases. The analysis included neonates, infants, and adults, and identified covariates that influence sirolimus pharmacokinetics (PK). The final model was used to predict sirolimus trough concentrations for various dosing regimens and covariates of interest. The results showed that sirolimus trough concentrations were predicted to increase with higher levels of hemoglobin, and that the granule formulation had a 1.23-fold higher exposure than the tablet formulation. Coadministration of CYP3A4 inducers was found to decrease trough concentrations by 54 %. The PK simulations showed that administration of the granule formulation at doses of 0.02, 0.04, 0.06, and 0.08 mg/kg/day in ages <3 months, 3 to <6 months, 6 to <12 months, and ≥1 year, respectively, resulted in >70 % target attainment within the therapeutic trough concentration range (5–15 ng/mL). In conclusion, incorporation of time-varying covariates (body weight and age) into the PopPK model appropriately predicted sirolimus concentrations in Japanese subjects from infants to adult sub-populations. This PopPK model would therefore be able to provide a reference for clinical individualization of sirolimus dosing.
利用 215 名日本人口服西罗莫司(片剂和颗粒剂)的数据进行了群体药代动力学(PopPK)分析,其中包括健康受试者和患有难治性血管异常和其他疾病的患者。该分析包括新生儿、婴儿和成人,并确定了影响西罗莫司药代动力学(PK)的协变量。最终模型用于预测不同给药方案和相关协变量下的西罗莫司谷浓度。结果表明,西罗莫司的谷浓度会随着血红蛋白水平的升高而增加,颗粒剂的暴露量是片剂的 1.23 倍。同时服用 CYP3A4 诱导剂会使谷浓度降低 54%。PK 模拟显示,按 0.02、0.04、0.06 和 0.08 毫克/千克/天的剂量服用颗粒制剂,70% 的年龄组可达到治疗谷浓度范围(5-15 毫微克/毫升)内的目标值。总之,在 PopPK 模型中加入随时间变化的协变量(体重和年龄)可适当预测日本受试者从婴儿到成人亚群的西罗莫司浓度。因此,该PopPK模型可为西罗莫司的临床个体化用药提供参考。
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引用次数: 0
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