Department of Pharmaceutical Sciences, 565 B Hochstetter Hall, State University of New York at Buffalo, Buffalo, NY 14260, USA.
J Clin Pharmacol. 2012 Nov;52(11):1624-44. doi: 10.1177/0091270011421911. Epub 2011 Dec 12.
The aim of this study was to develop an integrated pharmacokinetic and pharmacodynamic (PK/PD) model and assess the comparability between epoetin alfa HEXAL/Binocrit (HX575) and a comparator epoetin alfa by a model-based approach. PK/PD data-including serum drug concentrations, reticulocyte counts, red blood cells, and hemoglobin levels-were obtained from 2 clinical studies. In sum, 149 healthy men received multiple intravenous or subcutaneous doses of HX575 (100 IU/kg) and the comparator 3 times a week for 4 weeks. A population model based on pharmacodynamics-mediated drug disposition and cell maturation processes was used to characterize the PK/PD data for the 2 drugs. Simulations showed that due to target amount changes, total clearance may increase up to 2.4-fold as compared with the baseline. Further simulations suggested that once-weekly and thrice-weekly subcutaneous dosing regimens would result in similar efficacy. The findings from the model-based analysis were consistent with previous results using the standard noncompartmental approach demonstrating PK/PD comparability between HX575 and comparator. However, due to complexity of the PK/PD model, control of random effects was not straightforward. Whereas population PK/PD model-based analyses are suited for studying complex biological systems, such models have their limitations (statistical), and their comparability results should be interpreted carefully.
本研究旨在开发一个整合的药代动力学和药效学(PK/PD)模型,并通过基于模型的方法评估 epoetin alfa HEXAL/Binocrit(HX575)与对照药物的可比性。PK/PD 数据——包括血清药物浓度、网织红细胞计数、红细胞和血红蛋白水平——来自两项临床研究。共有 149 名健康男性接受了 HX575(100IU/kg)和对照药物的多次静脉或皮下给药,每周 3 次,共 4 周。基于药效学介导的药物分布和细胞成熟过程的群体模型用于描述两种药物的 PK/PD 数据。模拟表明,由于靶标数量的变化,总清除率可能比基线增加高达 2.4 倍。进一步的模拟表明,每周一次和每周三次皮下给药方案将产生相似的疗效。基于模型的分析结果与使用标准非房室分析的先前结果一致,表明 HX575 与对照药物之间具有 PK/PD 可比性。然而,由于 PK/PD 模型的复杂性,对随机效应的控制并不简单。虽然基于群体 PK/PD 模型的分析适合研究复杂的生物系统,但这些模型存在其局限性(统计学),其可比性结果应谨慎解释。