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儿童脂质体柔红霉素的群体药代动力学

Population pharmacokinetics of liposomal daunorubicin in children.

作者信息

Hempel Georg, Reinhardt Dirk, Creutzig Ursula, Boos Joachim

机构信息

Institut für Pharmazeutische und Medizinische Chemie, Westfälische Wilhelms-Universität, Hittorfstrasse 58-62, 48149 Münster, Germany.

出版信息

Br J Clin Pharmacol. 2003 Oct;56(4):370-7. doi: 10.1046/j.1365-2125.2003.01886.x.

Abstract

AIMS

To investigate the population pharmacokinetics of daunorubicin in children after administration of liposomal daunorubicin (Daunoxome).

METHODS

Plasma samples from 19 children with relapsed acute myeloic leukaemia and five children with other malignancies were collected. Daunoxome was administered as a 1- to 2.5 h infusion with doses ranging from 30 to 60 mg m(-2). Overall, 214 samples were analysed for daunorubicin using capillary electrophoresis, and population pharmacokinetic modelling was performed using NONMEM.

RESULTS

The data were best described by a one compartment model. Inclusion of interoccasion variability in the model (16.7% for clearance) improved strongly the precision of the estimates. The inclusion of body surface area or height as a covariate decreased interindividual variability. However, the best fit was obtained using the absolute dose, and when weight was included as a covariate for clearance (CL) and volume of distribution (V ). The final parameter estimates were: CL 6.41 ml h(-1) kg(-1) +/- 0.5 51% and V 65.4 ml kg(-1) +/- 0.5 27% (population mean +/- 0.5 interindividual variability). The area under the curve at a dose of 60 mg m(-2) was 231 mg l (-1)h.

CONCLUSIONS

In comparison with free daunorubicin, Daunoxome shows a low volume of distribution, a lower clearance and a lower interindividual variability in these parameters. This might be advantageous in reducing the variability in exposure to the drug.

摘要

目的

研究脂质体柔红霉素(Daunoxome)给药后儿童柔红霉素的群体药代动力学。

方法

收集了19例复发急性髓性白血病儿童和5例其他恶性肿瘤儿童的血浆样本。Daunoxome以1至2.5小时的输注方式给药,剂量范围为30至60mg/m²。总体而言,使用毛细管电泳分析了214份样本中的柔红霉素,并使用NONMEM进行群体药代动力学建模。

结果

数据用单室模型能得到最佳描述。在模型中纳入给药间隔间的变异性(清除率为16.7%)显著提高了估计的精度。将体表面积或身高作为协变量纳入可降低个体间变异性。然而,使用绝对剂量并将体重作为清除率(CL)和分布容积(V)的协变量时能得到最佳拟合。最终参数估计值为:CL 6.41ml·h⁻¹·kg⁻¹±0.5 51%,V 65.4ml·kg⁻¹±0.5 27%(群体均值±0.5个体间变异性)。60mg/m²剂量下的曲线下面积为231mg·l⁻¹·h。

结论

与游离柔红霉素相比,Daunoxome在这些参数上显示出较低的分布容积、较低的清除率和较低的个体间变异性。这可能有利于降低药物暴露的变异性。

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