处理药效学基线反应的方法。

Approaches to handling pharmacodynamic baseline responses.

作者信息

Dansirikul Chantaratsamon, Silber Hanna E, Karlsson Mats O

机构信息

Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.

出版信息

J Pharmacokinet Pharmacodyn. 2008 Jun;35(3):269-83. doi: 10.1007/s10928-008-9088-2. Epub 2008 Apr 30.

Abstract

A few approaches for handling baseline responses are available for use in pharmacokinetic (PK)-pharmacodynamic (PD) analysis. They include: (method 1-B1) estimation of the typical value and interindividual variability (IIV) of baseline in the population, (B2) inclusion of the observed baseline response as a covariate acknowledging the residual variability, (B3) a more general version of B2 as it also takes the IIV of the baseline in the population into account, and (B4) normalization of all observations by the baseline value. The aim of this study was to investigate the relative performance of B1-B4. PD responses over a single dosing interval were simulated from an indirect response model in which a drug acts through stimulation or inhibition of the response according to an Emax model. The performance of B1-B4 was investigated under 22 designs, each containing 100 datasets. NONMEM VI beta was used to estimate model parameters with the FO and the FOCE method. The mean error (ME, %) and root mean squared error (RMSE, %) of the population parameter estimates were computed and used as an indicator of bias and imprecision. Absolute ME (|ME|) and RMSE from all methods were ranked within the same design, the lower the rank value the better method performance. Average rank of each method from all designs was reported. The results showed that with B1 and FOCE, the average of |ME| and RMSE across all typical individual parameters and all conditions was 5.9 and 31.8%. The average rank of |ME| for B1, B2, B3, and B4 was 3.7, 3.8, 3.3, and 5.2 for the FOCE method, and 4.6, 4.3, 4.7, and 6.4 for the FO method. The smallest imprecision was noted with the use of B1 (rank of 3.1 for FO, and 2.9 for FOCE) and increased, in order, with B3 (3.9-FO and 3.6-FOCE), B2 (4.8-FO; 4.7-FOCE), and B4 (6.4-FO; 6.5-FOCE). We conclude that when considering both bias and imprecision B1 was slightly better than B3 which in turn was better than B2. Differences between these methods were small. B4 was clearly inferior. The FOCE method led to a smaller bias, but no marked reduction in imprecision of parameter estimates compared to the FO method.

摘要

在药代动力学(PK)-药效学(PD)分析中,可以使用几种处理基线反应的方法。它们包括:(方法1-B1)估计总体中基线的典型值和个体间变异性(IIV),(B2)将观察到的基线反应作为协变量纳入,同时考虑残留变异性,(B3)B2的更通用版本,因为它也考虑了总体中基线的IIV,以及(B4)用基线值对所有观察值进行标准化。本研究的目的是调查B1 - B4的相对性能。在一个间接反应模型中模拟了单次给药间隔内的PD反应,在该模型中,药物根据Emax模型通过刺激或抑制反应起作用。在22种设计下研究了B1 - B4的性能,每种设计包含100个数据集。使用NONMEM VI beta软件,采用一阶条件估计法(FO)和一阶条件估计法(FOCE)估计模型参数。计算总体参数估计值的平均误差(ME,%)和均方根误差(RMSE,%),并将其用作偏差和不精确性的指标。在同一设计中对所有方法的绝对ME(|ME|)和RMSE进行排序,排名值越低,方法性能越好。报告了每种方法在所有设计中的平均排名。结果表明,使用B1和FOCE方法时,所有典型个体参数和所有条件下|ME|和RMSE的平均值分别为5.9%和31.8%。对于FOCE方法,B1、B2、B3和B4的|ME|平均排名分别为3.7、3.8、3.3和5.2;对于FO方法,分别为4.6、4.3、4.7和6.4。使用B1时不精确性最小(FO排名为3.1,FOCE排名为2.9),其次依次是B3(FO为3.9,FOCE为3.6)、B2(FO为4.8,FOCE为4.7)和B4(FO为6.4,FOCE为6.5)。我们得出结论,在同时考虑偏差和不精确性时,B1略优于B3,B3又优于B2。这些方法之间的差异很小。B4明显较差。与FO方法相比,FOCE方法导致的偏差较小,但参数估计的不精确性没有明显降低。

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