Claret L, Iliadis A, Macheras P
Chair of Population Pharmacokinetics, Faculty of Pharmacy, University of Montreal, Canada.
J Pharmacokinet Pharmacodyn. 2001 Oct;28(5):445-63. doi: 10.1023/a:1012295014352.
The pharmacokinetics of cyclosporin (CsA) are unusual because of several heterogeneous features which include the presence of more than one conformer, considerable accumulation in erythrocytes and lipoproteins, extensive plasma protein binding, distribution into deep tissues, biliary secretion and hepatic clearance involving a large number of metabolites. In this study, a stochastic compartmental model was developed to describe the heterogeneous elimination kinetics of CsA. This new approach relies on a probabilistic transfer model with a gamma distributed probability intensity coefficient for drug elimination. For comparative purposes both the stochastic model and compartmental deterministic models were fitted to real post infusion data from patients receiving CsA as a 2-hr intravenous infusion. The criteria for selecting the best model showed that the stochastic model, although simpler than the compartmental deterministic models, is more flexible and gives a better fit to the kinetic data of CsA than the compartmental deterministic models. The stochastic model with a random rate intensity coefficient adequately describes the heterogeneous pharmacokinetics of CsA.
环孢素(CsA)的药代动力学较为特殊,因为它具有几个异质性特征,包括存在不止一种构象异构体、在红细胞和脂蛋白中大量蓄积、广泛的血浆蛋白结合、分布至深部组织、胆汁分泌以及涉及大量代谢产物的肝脏清除。在本研究中,开发了一个随机房室模型来描述CsA的异质性消除动力学。这种新方法依赖于一种概率转移模型,该模型具有用于药物消除的伽马分布概率强度系数。为了进行比较,将随机模型和房室确定性模型都拟合到接受2小时静脉输注CsA的患者的实际输注后数据。选择最佳模型的标准表明,随机模型虽然比房室确定性模型更简单,但更灵活,并且比房室确定性模型更能拟合CsA的动力学数据。具有随机速率强度系数的随机模型充分描述了CsA的异质性药代动力学。