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聚乙二醇干扰素 alfa-2b 在慢性丙型肝炎儿科患者中的群体药代动力学。

Population pharmacokinetics of peginterferon alfa-2b in pediatric patients with chronic hepatitis C.

机构信息

Merck Research Laboratories, Kenilworth, NJ, USA,

出版信息

Eur J Clin Pharmacol. 2013 Dec;69(12):2045-54. doi: 10.1007/s00228-013-1574-9. Epub 2013 Aug 24.

Abstract

PURPOSE

The aim of this study was to characterize the population pharmacokinetics of peginterferon (PEG-IFN) alfa-2b in pediatric patients with chronic hepatitis C and to identify covariates influencing PEG-IFN alfa-2b disposition.

METHODS

Pharmacokinetic data from a multicenter open-label study of subcutaneously administered peginterferon alfa-2b (60 μg/m(2)/wk) plus oral ribavirin (15 mg/kg/day) in patients with chronic hepatitis C aged 3-17 years old was used to develop a population pharmacokinetic nonlinear mixed-effects model.

RESULTS

The final population pharmacokinetic analysis was conducted with the pooled data from 107 pediatric patients. A one-compartment model with first-order absorption, first-order elimination, exponential inter-individual variability on clearance, and a combination additive and proportional residual error model adequately described the PEG-IFN alfa-2b pharmacokinetic profile. Age (apparent clearance and apparent volume of distribution) and sex (apparent clearance) were significant covariates. The mean body surface area normalized apparent clearance of PEG-IFN alfa-2b was 0.56 L/h/m(2), and was similar when evaluated across the pediatric age groups.

CONCLUSION

The final population model suggests age-dependent increases in clearance and volume of distribution of PEG-IFN alfa-2b in pediatric patients with chronic hepatitis C. The apparent clearance normalized to body surface area was similar across pediatric age groups, supporting the use of body size-adjusted dosing in pediatric subjects.

摘要

目的

本研究旨在描述慢性丙型肝炎患儿聚乙二醇干扰素(PEG-IFN)alfa-2b 的群体药代动力学特征,并确定影响 PEG-IFN alfa-2b 处置的协变量。

方法

使用多中心、开放性研究的药代动力学数据,对年龄为 3-17 岁的慢性丙型肝炎患儿皮下给予 PEG-IFN alfa-2b(60 μg/m²/周)联合口服利巴韦林(15 mg/kg/天),以开发群体药代动力学非线性混合效应模型。

结果

对 107 例儿科患者的汇总数据进行了最终的群体药代动力学分析。一个一室模型,具有一级吸收、一级消除、清除率的个体间指数变异以及加性和比例残留误差模型的组合,可充分描述 PEG-IFN alfa-2b 的药代动力学特征。年龄(表观清除率和表观分布容积)和性别(表观清除率)是显著的协变量。PEG-IFN alfa-2b 的平均体表面积归一化表观清除率为 0.56 L/h/m²,在儿科年龄组之间评估时相似。

结论

最终的群体模型表明,慢性丙型肝炎患儿的 PEG-IFN alfa-2b 清除率和分布容积随年龄增长而增加。按体表面积归一化的表观清除率在儿科年龄组之间相似,支持在儿科受试者中使用基于体大小调整的剂量。

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