Centre for Pharmacokinetic Research, University of Manchester, United Kingdom.
Annu Rev Pharmacol Toxicol. 2011;51:45-73. doi: 10.1146/annurev-pharmtox-010510-100540.
The application of physiologically-based pharmacokinetic (PBPK) modeling is coming of age in drug development and regulation, reflecting significant advances over the past 10 years in the predictability of key pharmacokinetic (PK) parameters from human in vitro data and in the availability of dedicated software platforms and associated databases. Specific advances and contemporary challenges with respect to predicting the processes of drug clearance, distribution, and absorption are reviewed, together with the ability to anticipate the quantitative extent of PK-based drug-drug interactions and the impact of age, genetics, disease, and formulation. The value of this capability in selecting and designing appropriate clinical studies, its implications for resource-sparing techniques, and a more holistic view of the application of PK across the preclinical/clinical divide are considered. Finally, some attention is given to the positioning of PBPK within the drug development and approval paradigm and its future application in truly personalized medicine.
生理药代动力学(PBPK)模型的应用在药物开发和监管中已经成熟,这反映了过去 10 年来在从人体体外数据预测关键药代动力学(PK)参数的可预测性方面取得了重大进展,以及专用软件平台和相关数据库的可用性。本文回顾了在预测药物清除、分布和吸收过程方面的具体进展和当代挑战,以及预测基于 PK 的药物相互作用的定量程度和年龄、遗传、疾病和配方的影响的能力。本文还考虑了这种能力在选择和设计适当的临床研究中的价值、对节省资源技术的影响,以及在临床前/临床分界线内应用 PK 的更全面的观点。最后,本文还关注了 PBPK 在药物开发和审批模式中的定位及其在真正的个性化医学中的未来应用。