Bellissant E, Courcier-Duplantier S, Blin O
Laboratoire de Pharmacologie Expérimentale et Clinique, Rennes, France.
Therapie. 2002 Jul-Aug;57(4):347-57.
An important part of drug development relies on the analysis of the relationships between drug doses and therapeutic and/or side effects. This analysis implies an in-depth understanding of the pharmacokinetics (PK) and pharmacodynamics (PD) of the drug and of the relationship which links them (PK-PD relationship). The aim of this round table was to define the place of the study of PK-PD relationships in drug development. After reviewing the definitions of PK models, PD models, and of integrated PK-PD models, the article highlights the importance of studying the PK-PD relationship during the successive phases of drug development (pre-clinical, phase I/II, phase III) and in specific populations (children, elderly people). A number of examples taken from pharmaceutical development or international literature are given. They show the methodology used and the type of information which can be drawn at each step of drug development. The article also presents the difficulties which prevent a more systematic application of this kind of approach during drug development. Scientific limits, problems in relation with the misunderstanding of the approach both in academic institutions and in pharmaceutical companies, and difficulties related to the lack of specific guidelines are discussed. The conclusion emphasizes the importance of using PK-PD modeling all along drug development and presents a number of actions which could further broaden its use.
药物研发的一个重要部分依赖于对药物剂量与治疗效果和/或副作用之间关系的分析。这种分析意味着要深入了解药物的药代动力学(PK)和药效动力学(PD)以及将它们联系起来的关系(PK-PD关系)。本次圆桌会议的目的是确定PK-PD关系研究在药物研发中的地位。在回顾了PK模型、PD模型以及整合的PK-PD模型的定义后,本文强调了在药物研发的连续阶段(临床前、I/II期、III期)以及特定人群(儿童、老年人)中研究PK-PD关系的重要性。文中给出了一些来自药物研发或国际文献的例子。这些例子展示了所使用的方法以及在药物研发的每个步骤中可以获取的信息类型。本文还介绍了在药物研发过程中阻碍这种方法更系统应用的困难。讨论了科学局限性、学术机构和制药公司对该方法的误解相关问题以及与缺乏具体指导方针有关的困难。结论强调了在整个药物研发过程中使用PK-PD建模的重要性,并提出了一些可以进一步扩大其应用的行动。