Ecole Nationale Vétérinaire de Toulouse, UMR 181 de Physiopathologie et Toxicologie Expérimentales INRA, ENVT 23, chemin des Capelles-BP 87614-31076 Toulouse CEDEX, France.
Equine Vet J. 2010 Apr;42(3):248-54. doi: 10.1111/j.2042-3306.2010.00028.x.
For legitimate medications, veterinarians must advise the owners or trainers of horses on appropriate withholding times after a treatment, to avoid the risk of incurring a positive drug test.
To explore the safety span to select that a veterinarian may extrapolate a tailored withdrawal time (WT) from a generic detection time (DT) as published by the European Horserace Scientific Liaison Committee (EHSLC).
Using Monte Carlo simulations, it was shown that for a low variability of pharmacokinetic parameters (CV=20%), an uncertainty span of about 40% may be selected to transform a mean DT into a WT (i.e. WT=1.4 DT), which covers 90% of the horse population. In contrast for a highly variable drug (CV=40%), an uncertainty factor of about 2.1-2.2 needs to be selected, i.e. a WT that is twice the DT.
The relative impact of the different factors of variability on the final WT was documented by a so-called sensitivity analysis. It was shown that the parameters that have the greatest influence on the value of a DT are those that control the terminal half-life of the drug disposition. In contrast, parameters controlling the level of urine (or plasma) concentrations (i.e. the actual administered dose, the urine-to-plasma ratio and the bioavailability) collectively have a minimal influence on the DT.
In practice, this means that the main sources of uncertainty are of biological origin and cannot be reduced by any managerial options. The influence of the number of experimental horses that are used by EHSLC to establish a DT was shown that with the standard EHLSC protocol of 6 horses, half of the trials lead to a proposed DT that is equal to or higher than the population 90(th) percentile. Increasing the number of investigated horses to 8 and 10 would increase this last probability to 85 and 90%, respectively.
对于合法药物,兽医必须在治疗后告知马的主人或训练师适当的停药时间,以避免药物检测呈阳性的风险。
探索安全范围,以便兽医可以从欧洲赛马科学联络委员会(EHSLC)公布的通用检测时间(DT)中推断出定制的停药时间(WT)。
通过蒙特卡罗模拟,结果表明,对于药代动力学参数变异性低(CV=20%)的情况,可以选择大约 40%的不确定性范围将平均 DT 转换为 WT(即 WT=1.4 DT),这涵盖了 90%的马群。相比之下,对于变异性高的药物(CV=40%),需要选择大约 2.1-2.2 的不确定性系数,即 WT 是 DT 的两倍。
通过所谓的敏感性分析,记录了不同变异性因素对最终 WT 的相对影响。结果表明,对 DT 值影响最大的参数是控制药物处置终端半衰期的参数。相比之下,控制尿液(或血浆)浓度水平的参数(即实际给予的剂量、尿液与血浆的比值和生物利用度)对 DT 的影响最小。
在实践中,这意味着主要的不确定性来源是生物源性的,无法通过任何管理选项来降低。EHSLC 用于建立 DT 的实验马数量的影响表明,使用 EHSLC 的标准协议 6 匹马,一半的试验导致提出的 DT 等于或高于群体第 90 百分位数。将研究的马匹数量增加到 8 匹马和 10 匹马,将分别将最后一个概率提高到 85%和 90%。