Brvar Nina, Mateović-Rojnik Tatjana, Grabnar Iztok
Krka, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo Mesto, Slovenia.
University of Ljubljana, Faculty of Pharmacy, Aškerčeva cesta 7, 1000 Ljubljana, Slovenia.
Int J Pharm. 2014 Oct 1;473(1-2):170-8. doi: 10.1016/j.ijpharm.2014.07.013. Epub 2014 Jul 8.
This study aimed to develop a population pharmacokinetic model for tramadol that combines different input rates with disposition characteristics. Data used for the analysis were pooled from two phase I bioavailability studies with immediate (IR) and prolonged release (PR) formulations in healthy volunteers. Tramadol plasma concentration-time data were described by an inverse Gaussian function to model the complete input process linked to a two-compartment disposition model with first-order elimination. Although polymorphic CYP2D6 appears to be a major enzyme involved in the metabolism of tramadol, application of a mixture model to test the assumption of two and three subpopulations did not reveal any improvement of the model. The final model estimated parameters with reasonable precision and was able to estimate the interindividual variability of all parameters except for the relative bioavailability of PR vs. IR formulation. Validity of the model was further tested using the nonparametric bootstrap approach. Finally, the model was applied to assess absorption kinetics of tramadol and predict steady-state pharmacokinetics following administration of both types of formulations. For both formulations, the final model yielded a stable estimate of the absorption time profiles. Steady-state simulation supports switching of patients from IR to PR formulation.
本研究旨在建立一个将不同输入速率与处置特征相结合的曲马多群体药代动力学模型。用于分析的数据来自两项在健康志愿者中开展的关于速释(IR)和缓释(PR)制剂的I期生物利用度研究。曲马多血浆浓度-时间数据采用反高斯函数进行描述,以模拟与具有一级消除的二室处置模型相关的完整输入过程。尽管多态性CYP2D6似乎是参与曲马多代谢的主要酶,但应用混合模型来检验两个和三个亚群的假设并未显示该模型有任何改进。最终模型以合理的精度估计参数,并且能够估计除PR与IR制剂的相对生物利用度之外的所有参数的个体间变异性。使用非参数自助法进一步检验了模型的有效性。最后,该模型被应用于评估曲马多的吸收动力学,并预测两种制剂给药后的稳态药代动力学。对于两种制剂,最终模型均对吸收时间曲线给出了稳定的估计。稳态模拟支持患者从IR制剂转换为PR制剂。