Kimura Koji, Yoshida Atsushi, Takayanagi Risa, Yamada Yasuhiko
Department of Clinical Evaluation of Drug Efficacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan.
Center for Gastroenterology and Inflammatory Bowel Disease Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa, 247-0056, Japan.
Biopharm Drug Dispos. 2018 Jun;39(6):283-288. doi: 10.1002/bdd.2134. Epub 2018 Jun 11.
Adalimumab (ADA) is used as a therapeutic agent for Crohn's disease (CD). Although the dosage regimen has been established through clinical trial experience, it has not been analysed theoretically. The present study analysed of sequential changes in the Crohn's disease activity index (CDAI) after repeated administrations of adalimumab using a pharmacokinetic and pharmacodynamic model. In addition, we analysed the validity of the dosage regimen, and the potential efficacy gained by increasing the dose and reducing the interval of administration. The sequential changes in CDAI values obtained with our model were in good agreement with observed CDAI values, which is considered to show the validity of our analysis. We consider that our results showed the importance of a loading dose of adalimumab to obtain remission in an early stage of active CD. In addition, we showed that patients who have an incomplete response to adalimumab can obtain similar efficacy from increasing the dose and reducing the dose interval. In conclusion, our results showed that the present model may be applied to predict the CDAI values of adalimumab for CD. They indicate the validity of the dosage regimen, as well as the efficacy of increasing the dose and reducing the dose interval.
阿达木单抗(ADA)被用作克罗恩病(CD)的治疗药物。尽管其给药方案已通过临床试验经验确定,但尚未进行理论分析。本研究使用药代动力学和药效学模型分析了重复给予阿达木单抗后克罗恩病活动指数(CDAI)的连续变化。此外,我们分析了给药方案的有效性,以及增加剂量和缩短给药间隔可能获得的疗效。我们模型获得的CDAI值的连续变化与观察到的CDAI值高度一致,这被认为表明了我们分析的有效性。我们认为我们的结果显示了阿达木单抗负荷剂量在活动期CD早期实现缓解的重要性。此外,我们表明对阿达木单抗反应不完全的患者可以通过增加剂量和缩短给药间隔获得相似的疗效。总之,我们的结果表明,当前模型可用于预测阿达木单抗治疗CD的CDAI值。它们表明了给药方案的有效性,以及增加剂量和缩短给药间隔的疗效。