Journal of clinical pharmacology最新文献

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Population Pharmacokinetics and Target Engagement of Natalizumab in Patients With Multiple Sclerosis. Natalizumab在多发性硬化症患者中的群体药代动力学和靶标参与。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-11 DOI: 10.1002/jcph.894
Kumar Kandadi Muralidharan, Geoffrey Kuesters, Tatiana Plavina, Meena Subramanyam, Daniel D Mikol, Sreeja Gopal, Ivan Nestorov
{"title":"Population Pharmacokinetics and Target Engagement of Natalizumab in Patients With Multiple Sclerosis.","authors":"Kumar Kandadi Muralidharan,&nbsp;Geoffrey Kuesters,&nbsp;Tatiana Plavina,&nbsp;Meena Subramanyam,&nbsp;Daniel D Mikol,&nbsp;Sreeja Gopal,&nbsp;Ivan Nestorov","doi":"10.1002/jcph.894","DOIUrl":"https://doi.org/10.1002/jcph.894","url":null,"abstract":"<p><p>Natalizumab (humanized immunoglobulin G4 antibody targeting alpha-4 integrins) is a highly efficacious treatment for relapsing-remitting multiple sclerosis (RRMS) that has been in clinical use since 2006. However, natalizumab pharmacokinetic (PK) characteristics and concentration alpha-4 integrin saturation relationships have not been well described in the scientific literature. Therefore, clinical data from 11 studies were pooled and analyzed to characterize the PK and pharmacodynamic (PD) properties of natalizumab in RRMS subjects. Natalizumab PK was best described using a 2-compartment model with linear first-order and Michaelis-Menten elimination. Subcutaneous absorption of natalizumab was characterized using first-order absorption with lag time. The relationship between natalizumab concentration and alpha-4 integrin saturation (PD) was best described by a direct response model with a sigmoidal effect on alpha-4 integrin saturation mediated by a maximum effect relationship with natalizumab concentrations. Covariate analysis showed that body weight, product formulations, and the presence of antinatalizumab antibodies were the main covariates affecting natalizumab PK, whereas age and formulations affected PD. The use of simulations based on a pharmacokinetic-pharmacodynamic model showed that covariates, although statistically significant, are not expected to have any clinical impact at the approved clinical dosing regimen of natalizumab (300 mg once every 4 weeks).</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"1017-1030"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34904004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
Model-Based Evaluation of Exenatide Effects on the QT Interval in Healthy Subjects Following Continuous IV Infusion. 基于模型的持续静脉输注艾塞那肽对健康受试者QT间期影响的评价
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-05-22 DOI: 10.1002/jcph.882
Brenda Cirincione, Frank LaCreta, Philip Sager, Donald E Mager
{"title":"Model-Based Evaluation of Exenatide Effects on the QT Interval in Healthy Subjects Following Continuous IV Infusion.","authors":"Brenda Cirincione,&nbsp;Frank LaCreta,&nbsp;Philip Sager,&nbsp;Donald E Mager","doi":"10.1002/jcph.882","DOIUrl":"https://doi.org/10.1002/jcph.882","url":null,"abstract":"<p><p>Investigation of the cardiovascular proarrhythmic potential of a new chemical entity is now an integral part of drug development. Studies suggest that meals and glycemic changes can influence QT intervals, and a semimechanistic model has been developed that incorporates the effects of changes in glucose concentrations on heart rate (HR) and QT intervals. This analysis aimed to adapt the glucose-HR-QT model to incorporate the effects of exenatide, a drug that reduces postprandial increases in glucose concentrations. The final model includes stimulatory drug effects on glucose elimination and HR perturbations. The targeted and constant exenatide plasma concentrations (>200 pg/mL), via intravenous infusions at multiple dose levels, resulted in significant inhibition of glucose concentrations. The exenatide concentration associated with 50% of the stimulation of HR production was 584 pg/mL. After accounting for exenatide effects on glucose and HR, no additional drug effects were required to explain observed changes in the QT interval. Resulting glucose, HR, and QT profiles at all exenatide concentrations were adequately described. For therapeutic agents that alter glycemic conditions, particularly those that alter postprandial glucose, the QT interval cannot be directly compared to that with placebo without first accounting for confounding factors (eg, glucose) either through mathematical modeling or careful consideration of mealtime placement in the study design.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"956-965"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.882","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35028671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Population Pharmacokinetics of Nusinersen in the Cerebral Spinal Fluid and Plasma of Pediatric Patients With Spinal Muscular Atrophy Following Intrathecal Administrations. 鞘内给药后小儿脊髓肌萎缩患者脑脊液和血浆中Nusinersen的群体药代动力学
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-03-29 DOI: 10.1002/jcph.884
Kenneth T Luu, Daniel A Norris, Rudy Gunawan, Scott Henry, Richard Geary, Yanfeng Wang
{"title":"Population Pharmacokinetics of Nusinersen in the Cerebral Spinal Fluid and Plasma of Pediatric Patients With Spinal Muscular Atrophy Following Intrathecal Administrations.","authors":"Kenneth T Luu,&nbsp;Daniel A Norris,&nbsp;Rudy Gunawan,&nbsp;Scott Henry,&nbsp;Richard Geary,&nbsp;Yanfeng Wang","doi":"10.1002/jcph.884","DOIUrl":"https://doi.org/10.1002/jcph.884","url":null,"abstract":"<p><p>Nusinersen is an antisense oligonucleotide intended for the treatment of spinal muscular atrophy. The pharmacokinetics of nusinersen, following intrathecal administrations, in the cerebrospinal fluid (CSF) and plasma of 72 pediatric patients (3 months to 17 years) with spinal muscular atrophy across 5 clinical trials was analyzed via population-based modeling. With sparse data in the CSF and profile data in the plasma, a linear 4-compartment model simultaneously described the time-concentration profiles in both matrices. The typical population parameters were: Q<sub>p</sub> = 0.572 L/h, Q<sub>CSF</sub> = 0.069 L/h, CL<sub>p</sub> = 2.50 L/h, CL<sub>CSF</sub> = 0.133 L/hr, V<sub>CSF</sub> = 0.441 L, V<sub>p</sub> = 32.0 L, V<sub>systemic_tissue</sub> = 429 L, and V<sub>CNS_tissue</sub> = 258 L. A full covariate modeling approach identified baseline body weight to be a statistically and clinically relevant covariate on V<sub>CSF</sub> , V<sub>p</sub> , and CL<sub>p</sub> . The model predicted that the CSF volume of distribution increased steadily with age from 0 to 2 years but became relatively steady for children >2 years. Simulations from the final model showed that age-based dosing in children under 2 years ensured a more comparable exposure (peak concentration and area under the concentration-time curve) across subjects in the population relative to a fixed dosing scheme. However, because no dose-limiting toxicity has been reported in any of the trials, a fixed-dose scheme (12 mg across all age groups) was recommended. The median terminal half-life of nusinersen in the CSF was determined from the model to be 163 days, which supported infrequent dosing, once every 4 to 6 months in pediatric patients with spinal muscular atrophy.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"1031-1041"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34879680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 33
Regulatory and Ethical Issues in Pediatric Clinical Research: Recommendations From a Panel Discussion. 儿科临床研究中的监管和伦理问题:来自小组讨论的建议。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-05-17 DOI: 10.1002/jcph.916
Nilima Kshirsagar, Soumya Swaminathan, Pramod Jog, Samir Dalwai, Roli Mathur, Chandra Shekhar, Bernd Meibohm, Y K Gupta, Nusrat Shafiq, Gangadhar Sunkara, V G Somani, Prasad Kulkarni, Brian Tseng, Dhvani Mehta
{"title":"Regulatory and Ethical Issues in Pediatric Clinical Research: Recommendations From a Panel Discussion.","authors":"Nilima Kshirsagar,&nbsp;Soumya Swaminathan,&nbsp;Pramod Jog,&nbsp;Samir Dalwai,&nbsp;Roli Mathur,&nbsp;Chandra Shekhar,&nbsp;Bernd Meibohm,&nbsp;Y K Gupta,&nbsp;Nusrat Shafiq,&nbsp;Gangadhar Sunkara,&nbsp;V G Somani,&nbsp;Prasad Kulkarni,&nbsp;Brian Tseng,&nbsp;Dhvani Mehta","doi":"10.1002/jcph.916","DOIUrl":"https://doi.org/10.1002/jcph.916","url":null,"abstract":"Nilima Kshirsagar,MD, PhD, FNAS, FNAMS, FRCP (UK), FCP (USA)1, Soumya Swaminathan,Dip NB/MNAMS,MD,MBBS2, Pramod Jog,MD,DNB, FIAP3, Samir Dalwai,MD,DCH,DNB, FCPS, LLB4, Roli Mathur, PhD5, Chandra Shekhar,MD, MBBS5, Bernd Meibohm, PhD, FCP, FAAPS6, Y. K.Gupta,MBBS,MD, FAMS, FNASc, FIPS,FIAN7,Nusrat Shafiq,MD8,Gangadhar Sunkara, PhD9, V.G. Somani, PhD, MPharm10, Prasad Kulkarni,MD,MBBS11, Brian Tseng,MD, PhD12, and Dhvani Mehta,MPhil13","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"943-946"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35003100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Modeling and Simulation of Pivotal Clinical Trials Using Linked Models for Multiple Endpoints in Chronic Obstructive Pulmonary Disease With Roflumilast. 使用罗氟司特治疗慢性阻塞性肺疾病多终点关联模型的关键临床试验建模和模拟
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-17 DOI: 10.1002/jcph.885
Axel Facius, Andreas Krause, Laurent Claret, Rene Bruno, Gezim Lahu
{"title":"Modeling and Simulation of Pivotal Clinical Trials Using Linked Models for Multiple Endpoints in Chronic Obstructive Pulmonary Disease With Roflumilast.","authors":"Axel Facius,&nbsp;Andreas Krause,&nbsp;Laurent Claret,&nbsp;Rene Bruno,&nbsp;Gezim Lahu","doi":"10.1002/jcph.885","DOIUrl":"https://doi.org/10.1002/jcph.885","url":null,"abstract":"<p><p>Roflumilast is a selective phosphodiesterase 4 inhibitor (PDE4i) for the treatment of severe chronic obstructive pulmonary disease (COPD). In 2 large phase 3 trials in a broader population of COPD patients (BY217/M2-111, ClinicalTrials.gov: NCT00076089 and BY217/M2-112, ClinicalTrials.gov: NCT00430729), treatment with roflumilast reduced the rate of exacerbations; however, the reduction did not reach statistical significance. Two linked dose-response models for the primary (annualized COPD exacerbation counts) and secondary (change from baseline in forced expiratory volume in 1 second [FEV<sub>1</sub> ]) end points were therefore developed to characterize and quantify effect sizes and the patient characteristics influencing them. The models showed that disease severity and bronchitis, particularly the severity of bronchitis expressed in cough-and-sputum scores, were good predictors of exacerbation rates and differential benefit of roflumilast in exacerbation reduction. The models were used to support the rational design of 2 phase 3 randomized, placebo-controlled clinical trials (BY217/M2-124, ClinicalTrials.gov: NCT00297102 and BY217/M2-125, ClinicalTrials.gov: NCT00297115) by identifying the most appropriate patient population using clinical trial simulations. Model predictions for both end points were found to be highly accurate - as confirmed by the results from these trials, which led to the approval of roflumilast as the first oral PDE4i for the treatment of COPD in patients associated with chronic bronchitis and a history of exacerbations.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"1042-1052"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34922279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Antimuscarinic Use in Females With Overactive Bladder Syndrome Increases the Risk of Depressive Disorder: A 3-Year Follow-up Study. 女性膀胱过度活动综合征患者使用抗蛇毒碱增加抑郁障碍的风险:一项3年随访研究
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-05 DOI: 10.1002/jcph.890
Shiu-Dong Chung, Sung-Shun Weng, Chao-Yuan Huang, Herng-Ching Lin, Li-Ting Kao
{"title":"Antimuscarinic Use in Females With Overactive Bladder Syndrome Increases the Risk of Depressive Disorder: A 3-Year Follow-up Study.","authors":"Shiu-Dong Chung,&nbsp;Sung-Shun Weng,&nbsp;Chao-Yuan Huang,&nbsp;Herng-Ching Lin,&nbsp;Li-Ting Kao","doi":"10.1002/jcph.890","DOIUrl":"https://doi.org/10.1002/jcph.890","url":null,"abstract":"<p><p>To date, the relationship between antimuscarinics for overactive bladder (OAB) syndrome and depressive disorder still remains unclear. Therefore, this retrospective cohort study examined the association between antimuscarinic use and the subsequent risk of depressive disorder using a population-based data set. This study used data from the Taiwan Longitudinal Health Insurance Database 2005. We selected 1952 OAB women who received antimuscarinics as the study cohort and 9760 OAB women who did not receive antimuscarinics as the comparison cohort. Each subject was tracked for 3 years from her index date to determine all those who were subsequently diagnosed with depressive disorder. Results indicated that the adjusted hazard ratio (HR) for depressive disorder in OAB women who received antimuscarinics was 1.38 (95% confidence interval [CI], 1.15-1.64) compared with those OAB women who did not receive antimuscarinics. In addition, the adjusted HRs for subsequent depressive disorder for OAB women aged 18-39, 40-59, and ≥60 years who received antimuscarinics were 1.83 (95%CI, 1.27-2.64), 1.36 (95%CI, 1.03-1.81), and 1.16 (95%CI, 0.86-1.56), respectively, compared with those OAB women who did not receive antimuscarinics. We concluded that women with OAB who received antimuscarinics had a significantly higher risk of subsequent depressive disorder compared with those OAB women who did not receive antimuscarinics. Accordingly, clinicians should be alert to the relationship between antimuscarinics usage and depressive disorder in OAB women and provide appropriate instructions for these patients.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"1064-1070"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34887170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Results From the First-in-Human Study With Ozanimod, a Novel, Selective Sphingosine-1-Phosphate Receptor Modulator. Ozanimod是一种新型的选择性鞘氨醇-1-磷酸受体调节剂,首次在人体中进行研究。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-08-01 Epub Date: 2017-04-11 DOI: 10.1002/jcph.887
Jonathan Q Tran, Jeffrey P Hartung, Robert J Peach, Marcus F Boehm, Hugh Rosen, Heather Smith, Jennifer L Brooks, Gregg A Timony, Allan D Olson, Sheila Gujrathi, Paul A Frohna
{"title":"Results From the First-in-Human Study With Ozanimod, a Novel, Selective Sphingosine-1-Phosphate Receptor Modulator.","authors":"Jonathan Q Tran,&nbsp;Jeffrey P Hartung,&nbsp;Robert J Peach,&nbsp;Marcus F Boehm,&nbsp;Hugh Rosen,&nbsp;Heather Smith,&nbsp;Jennifer L Brooks,&nbsp;Gregg A Timony,&nbsp;Allan D Olson,&nbsp;Sheila Gujrathi,&nbsp;Paul A Frohna","doi":"10.1002/jcph.887","DOIUrl":"https://doi.org/10.1002/jcph.887","url":null,"abstract":"<p><p>The sphingosine-1-phosphate 1 receptor (S1P<sub>1R</sub> ) is expressed by lymphocytes, dendritic cells, and vascular endothelial cells and plays a role in the regulation of chronic inflammation and lymphocyte egress from peripheral lymphoid organs. Ozanimod is an oral selective modulator of S1P<sub>1R</sub> and S1P<sub>5R</sub> receptors in clinical development for the treatment of chronic immune-mediated, inflammatory diseases. This first-in-human study characterized the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of ozanimod in 88 healthy volunteers using a range of single and multiple doses (7 and 28 days) and a dose-escalation regimen. Ozanimod was generally well tolerated up to a maximum single dose of 3 mg and multiple doses of 2 mg/d, with no severe adverse events (AEs) and no dose-limiting toxicities. The most common ozanimod-related AEs included headache, somnolence, dizziness, nausea, and fatigue. Ozanimod exhibited linear PK, high steady-state volume of distribution (73-101 L/kg), moderate oral clearance (204-227 L/h), and an elimination half-life of approximately 17 to 21 hours. Ozanimod produced a robust dose-dependent reduction in total peripheral lymphocytes, with a median decrease of 65% to 68% observed after 28 days of dosing at 1 and 1.5 mg/d, respectively. Ozanimod selectivity affected lymphocyte subtypes, causing marked decreases in cells expressing CCR7 and variable decreases in subsets lacking CCR7. A dose-dependent negative chronotropic effect was observed following the first dose, with the dose-escalation regimen attenuating the first-dose negative chronotropic effect. Ozanimod safety, PK, and PD properties support the once-daily regimens under clinical investigation.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 8","pages":"988-996"},"PeriodicalIF":2.9,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34905865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 79
Electrophysiological Adverse Effects of Direct-Acting Antivirals in Patients With Chronic Hepatitis C. 直接作用抗病毒药物对慢性丙型肝炎患者的电生理不良反应。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-07-01 Epub Date: 2017-05-03 DOI: 10.1002/jcph.905
Roberto Rossotti, Lucio Jesus Garcia-Fraile Fraile, Chiara Baiguera, Massimo Puoti
{"title":"Electrophysiological Adverse Effects of Direct-Acting Antivirals in Patients With Chronic Hepatitis C.","authors":"Roberto Rossotti,&nbsp;Lucio Jesus Garcia-Fraile Fraile,&nbsp;Chiara Baiguera,&nbsp;Massimo Puoti","doi":"10.1002/jcph.905","DOIUrl":"https://doi.org/10.1002/jcph.905","url":null,"abstract":"Dear Editor, We read with great interest the article by DuranteMangoni et al.1 Sofosbuvir (SOF) has recently been correlated with bradyarrhythmias, especially if coadministered with amiodarone. In this study, DuranteMangoni et al assessed several electrocardiographic (ECG) parameters in 26 subjects who were consecutively treated with various SOF-based regimens. They did not observe significant changes in ECG parameters except a transient increase of QTc duration during the first week that returned to baseline values afterward. In contrast to what was reported by Renet et al2 and Fontaine et al,3 the authors concluded that SOF-based regimens could be considered safe. HIV/HCV coinfected patients are often treated with methadone and antiretrovirals, such as atazanavir and rilpivirine, which have an effect on QTc duration. Thus, we performed a similar evaluation of ECG parameters in 58 coinfected individuals treated with different SOFbased regimens from January 2015 to July 2016. ECG parameters were prospectively collected at baseline, after 1 and 4 weeks, and at the end of therapy. Compared to the study by Durante-Mangoni and colleagues, our population is larger and has several differences, especially in terms of liver fibrosis severity (Table 1). In the overall analysis, QTc duration did not change significantly over treatment (P= .31). Patients receiving atazanavir or rilpivirine had stable QTc intervals during treatment. No difference was noted for any directacting antiviral combination. At baseline, F3 (defined by a stiffness between 10 and 14 kPa) and cirrhotic subjects had comparable QTc values (408 milliseconds vs 422 milliseconds for F4 [defined by a stiffness >14 kPa] overall, 421 milliseconds for Child-Pugh-Turcotte class [CPT] A and 425 for CPT B/C), but such difference was not significant (P = .16). At week 4, F3 individuals maintained the same QTc value (407 milliseconds), but F4 patients had a slight increase to 424 milliseconds (P = 0.01). If we consider F3, CPT A (423 milliseconds), and CPT B/C Table 1. Baseline Features of Study Population","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 7","pages":"931-932"},"PeriodicalIF":2.9,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34962945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alternative Treatment Regimens With the PCSK9 Inhibitors Alirocumab and Evolocumab: A Pharmacokinetic and Pharmacodynamic Modeling Approach. PCSK9抑制剂Alirocumab和Evolocumab的替代治疗方案:药代动力学和药效学建模方法。
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-07-01 Epub Date: 2017-03-06 DOI: 10.1002/jcph.866
Nina Scherer, Christiane Dings, Michael Böhm, Ulrich Laufs, Thorsten Lehr
{"title":"Alternative Treatment Regimens With the PCSK9 Inhibitors Alirocumab and Evolocumab: A Pharmacokinetic and Pharmacodynamic Modeling Approach.","authors":"Nina Scherer,&nbsp;Christiane Dings,&nbsp;Michael Böhm,&nbsp;Ulrich Laufs,&nbsp;Thorsten Lehr","doi":"10.1002/jcph.866","DOIUrl":"https://doi.org/10.1002/jcph.866","url":null,"abstract":"<p><p>Alirocumab and evolocumab are 2 human monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9). These antibodies can potently lower low-density lipoprotein cholesterol (LDLc) serum concentrations. The aims of this analysis were to develop a pharmacokinetic (PK) and pharmacodynamic (PD) model for both antibodies, to simulate and investigate different dosage and application regimens, and finally, to note the effects on LDLc levels. Alirocumab was clinically studied and approved with 2 doses, 75 and 150 mg every 2 weeks (Q2W), whereas evolocumab was tested and approved with 2 dosing intervals, 140 mg Q2W and 420 mg Q4W. Data were digitized from published studies describing alirocumab and evolocumab PK, as well as LDLc levels in humans for various single and multiple doses. Alirocumab dosages ranged between 75 and 300 mg and evolocumab from 7 to 420 mg. The analysis was performed using a nonlinear mixed-effects modeling technique. A 2-compartment model with first-order absorption and saturable elimination described the PK of both antibodies best. LDLc levels were described by a turnover model with zero-order synthesis rate decreased by the antibodies and a first-order degradation rate that was increased by the antibodies. Simulations show a comparable effectiveness for alirocumab 75 mg Q2W and 150 mg Q3W as well as evolucmab 140 mg Q2W and 420 mg Q5W, respectively. This is the first PK/PD model describing the link between alirocumab and evolocumab PK and LDLc concentrations. The model may serve as an important tool to simulate different dosage regimens in order to optimize therapy.</p>","PeriodicalId":15536,"journal":{"name":"Journal of clinical pharmacology","volume":"57 7","pages":"846-854"},"PeriodicalIF":2.9,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jcph.866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34785806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Population Pharmacokinetic Modeling of Secukinumab in Patients With Moderate to Severe Psoriasis. 中度至重度银屑病患者Secukinumab的人群药代动力学模型
IF 2.9 4区 医学
Journal of clinical pharmacology Pub Date : 2017-07-01 Epub Date: 2017-03-08 DOI: 10.1002/jcph.876
Gerard Bruin, Christian Loesche, Judit Nyirady, Oliver Sander
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引用次数: 42
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