School of Pharmacy, The University of Jordan, Amman, 11942, Jordan.
Naunyn Schmiedebergs Arch Pharmacol. 2018 Sep;391(9):953-963. doi: 10.1007/s00210-018-1517-1. Epub 2018 Jun 5.
Neutropenia is a hematologic disorder commonly reported in patients with chronic hepatitis C viral (HCV) infection. The objective of the present analysis is to describe the change in neutrophil count resulting from peglated interferon alpha 2-a (PEG-IFN α-2a) therapy in HCV-infected patients. A population pharmacodynamic model will be developed. We also plan to identify patient characteristics that contribute to the development of PEG-IFN α-2a-induced neutropenia in hepatitis C patients. A population pharmacodynamic modeling approach was applied to a cohort of patients (n = 292) with chronic HCV infection. Modeling was performed using NONMEM 6. Data was obtained from two phases III studies sponsored by Hoffmann-La Roche. Covariate screening was applied to evaluate various demographic and clinical characteristics as possible predictors of pharmacodynamic parameter during model development. A total of 4517 neutrophil counts from 292 subjects were analyzed by the proposed population pharmacodynamic model. A constant residual error model was used to the log-transformed neutrophil count. Platelet baseline count and uric acid level were identified as predictors of neutrophil pharmacodynamic model. Increased baseline platelet count is expected to result in higher neutrophil baseline. A higher neutrophil baseline is also expected in patients with increased uric acid level. In conclusion, a mechanistic pharmacodynamic model was developed. The effect of various covariates was included in the model. This allows the prediction of neutrophil count following antiviral therapy in patients with hepatitis C infection. Clinical studies: NV15942 and NV15801.
中性粒细胞减少症是慢性丙型肝炎病毒(HCV)感染患者常见的血液学疾病。本分析的目的是描述聚乙二醇干扰素α-2a(PEG-IFNα-2a)治疗HCV 感染患者中性粒细胞计数的变化。将开发一种群体药代动力学模型。我们还计划确定导致丙型肝炎患者 PEG-IFNα-2a 诱导中性粒细胞减少的患者特征。应用群体药代动力学建模方法对 292 例慢性 HCV 感染患者进行了研究。使用 NONMEM 6 进行建模。数据来自 Hoffmann-La Roche 赞助的两项 III 期研究。协变量筛选用于评估各种人口统计学和临床特征,作为模型开发期间药效学参数的可能预测因子。通过提出的群体药效动力学模型分析了 292 例受试者的 4517 个中性粒细胞计数。采用常数残差模型对对数转换后的中性粒细胞计数进行建模。血小板基线计数和尿酸水平被确定为中性粒细胞药效动力学模型的预测因子。血小板基线计数的增加预计会导致中性粒细胞基线升高。尿酸水平升高的患者也预计会有更高的中性粒细胞基线。总之,建立了一个基于机制的药效动力学模型。模型中包含了各种协变量的影响。这允许预测丙型肝炎感染患者抗病毒治疗后中性粒细胞计数。临床研究:NV15942 和 NV15801。