评估在线伏立康唑剂量计算器对儿童的预测性能。

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI:10.1007/s00228-024-03762-x

Abdullah Alsultan, Razan Almofada, Sufyan Alomair, Eric F Egelund, Ahmed A Albassam, Mohammed Ali, Charles A Peloquin, Khalid W Taher

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引用次数: 0

摘要

背景：在儿科中，伏立康唑的剂量具有挑战性。改善剂量的一种方法是使用贝叶斯浓度指导剂量软件。我们的研究评估了免费提供的在线伏立康唑剂量计算器 "NextDose" ( https://www.nextdose.org/ )在儿科患者中的预测性能：我们根据每个剂量计算器预测伏立康唑的浓度。我们进行了先验贝叶斯预测和后验贝叶斯预测：本研究共纳入 51 名患者。先验预测的偏差为 + 26%，不精确度为 70%。后验预测的偏差和不精确度分别为 0.01% 和 46%：总之，在获得伏立康唑的观测数据之前，现有的在线剂量计算器对浓度的预测过高。不过，只需测量一次浓度，预测结果就会有所改善，偏差最小，不精确度也在可接受范围内。有必要开展更多前瞻性研究，评估伏立康唑剂量计算器在儿科人群中的使用情况，以评估与标准护理相比，它们是否能提高治疗目标浓度的实现。

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Evaluation of the predictive performance of an online voriconazole dose calculator in children.

Background: The dosing of voriconazole is challenging in pediatrics. One approach to improve the dosing is through the use of Bayesian concentration-guided dosing software. Our study assessed the predictive performance of a freely available online voriconazole dose calculator in pediatric patients "NextDose" ( https://www.nextdose.org/ ).

Methods: Per each dose calculator, we predicted voriconazole concentrations. We did both a priori and a posteriori Bayesian predictions.

Results: A total of 51 patients were included in this study. For a priori predictions, bias was + 26% while imprecision was 70%. For a posteriori predictions, bias and imprecision were 0.01% and 46%.

Discussion: In conclusion, the available online dose calculator was overpredicting the concentrations before voriconazole observations were available. However, with just one measured concentration, the predictions improved with minimal bias and an acceptable level of imprecision. There is a need for more prospective studies evaluating the use of voriconazole dosing calculators in the pediatric population to assess if they can improve the achievement of therapeutic target concentrations compared to standard of care.

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.