Sheng Lei, Qu Yi, Yan Jing, Liu Gang-Yi, Wang Wei-Liang, Wang Yi-Jun, Wang Hong-Yi, Zhang Meng-Qi, Lu Chuan, Liu Yun, Jia Jing-Yin, Hu Chao-Ying, Li Xue-Ning, Yu Chen, Xu Hong-Rong
Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Geriatrics, Central Hospital of Shanghai Xuhui, Shanghai 200031, China.
Acta Pharmacol Sin. 2016 Jul;37(7):994-1001. doi: 10.1038/aps.2016.24. Epub 2016 May 16.
Our preliminary results show that huperzine A, an acetylcholinesterase inhibitor used to treat Alzheimer's disease (AD) patients in China, exhibits different pharmacokinetic features in elderly and young healthy subjects. However, its pharmacokinetic data in elderly subjects remains unavailable to date. Thus, we developed a population pharmacokinetic (PPK) model of huperzine A in elderly Chinese people, and identified the covariate affecting its pharmacokinetics for optimal individual administration.
A total of 341 serum huperzine A concentration records was obtained from 2 completed clinical trials (14 elderly healthy subjects in a phase I pharmacokinetic study; 35 elderly AD patients in a phase II study). Population pharmacokinetic analysis was performed using the non-linear mixed-effect modeling software Phoenix NLME1.1.1. The effects of age, gender, body weight, height, creatinine, endogenous creatinine clearance rate as well as drugs administered concomitantly were analyzed. Bootstrap and visual predictive checks were used simultaneously to validate the final population pharmacokinetics models.
The plasma concentration-time profile of huperzine A was best described by a one-compartment model with first-order absorption and elimination. Age was identified as the covariate having significant influence on huperzine A clearance. The final PPK model of huperzine A was: CL (L/h)=2.4649(*)(age/86)((-3.3856)), Ka=0.6750 h(-1), V (L)=104.216. The final PPK model was demonstrated to be suitable and effective by the bootstrap and visual predictive checks.
A PPK model of huperzine A in elderly Chinese subjects is established, which can be used to predict PPK parameters of huperzine A in the treatment of elderly AD patients.
我们的初步研究结果表明,石杉碱甲,一种在中国用于治疗阿尔茨海默病(AD)患者的乙酰胆碱酯酶抑制剂,在老年和年轻健康受试者中表现出不同的药代动力学特征。然而,其在老年受试者中的药代动力学数据至今仍未可得。因此,我们建立了中国老年人群体中石杉碱甲的群体药代动力学(PPK)模型,并确定影响其药代动力学的协变量以实现最佳个体化给药。
从2项已完成的临床试验中获得了341条石杉碱甲血清浓度记录(1项I期药代动力学研究中的14名老年健康受试者;1项II期研究中的35名老年AD患者)。使用非线性混合效应建模软件Phoenix NLME1.1.1进行群体药代动力学分析。分析了年龄、性别、体重、身高、肌酐、内生肌酐清除率以及同时服用的药物的影响。同时使用自抽样法和可视化预测检查来验证最终的群体药代动力学模型。
石杉碱甲的血浆浓度-时间曲线以具有一级吸收和消除的单室模型最佳描述。年龄被确定为对石杉碱甲清除率有显著影响的协变量。石杉碱甲的最终PPK模型为:CL(L/h)=2.4649×(年龄/86)^(-3.3856),Ka = 0.6750 h^(-1),V(L)= 104.216。通过自抽样法和可视化预测检查证明最终的PPK模型是合适且有效的。
建立了中国老年受试者中石杉碱甲的PPK模型,可用于预测石杉碱甲在治疗老年AD患者中的PPK参数。