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药物研发临床前和临床阶段实验动物与人体之间的剂量转换

Dose translation between laboratory animals and human in preclinical and clinical phases of drug development.

作者信息

Nair Anroop, Morsy Mohamed Aly, Jacob Shery

机构信息

Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia.

Department of Pharmacology, Faculty of Medicine, Minia University, El-Minia, Egypt.

出版信息

Drug Dev Res. 2018 Dec;79(8):373-382. doi: 10.1002/ddr.21461. Epub 2018 Oct 21.

Abstract

Preclinical Research & Development Appropriate translation and determination of the maximum recommended starting dose in human is a vital task in new drug development and research. Allometric scaling is the most frequently used approach for dose extrapolation based on normalization of dose-to-body surface area. Misinterpretation of allometric dose conversion and safety factor application can lead to major problems in calculating maximum recommended safe starting dose in first-in-human clinical trials. Therefore, dose translation always necessitates careful consideration of body surface area, pharmacological, physiological and anatomical factors, pharmacokinetic parameters, metabolic function, receptor, and life span. The concept of estimating the first-in-human dose, interspecies scaling between species and the factors influencing the dose escalation were reviewed. The pros and cons of various approaches to determine first-in-human dose including allometric scaling, pharmacokinetically guided approach, minimal anticipated biological effect level, pharmacokinetic-pharmacodynamic modeling, similar drug approach, and microdosing were explained. The five steps to estimate maximum recommended starting dose for human studies by scaling factor were elaborated. Few examples, illustrating the application of different approaches were also demonstrated along with concerns that may be considered while applying such methods. Furthermore, typical considerations in dose administration, dosing through diet, maximum absorbable dose, blood sampling, and anesthesia in animal species were discussed. In summary, this review may serve as a concise guide for predicting human equivalent dose from animal species for researchers involved in various phases of preclinical and early clinical drug development.

摘要

临床前研究与开发 在新药研发中,合理翻译并确定人体最大推荐起始剂量是一项至关重要的任务。体表面积法是基于剂量与体表面积归一化进行剂量外推最常用的方法。对体表面积剂量转换和安全系数应用的错误解读可能会在首次人体临床试验中计算最大推荐安全起始剂量时导致重大问题。因此,剂量转换始终需要仔细考虑体表面积、药理、生理和解剖学因素、药代动力学参数、代谢功能、受体及寿命等。本文综述了估算首次人体剂量的概念、种间缩放以及影响剂量递增的因素。解释了确定首次人体剂量的各种方法的优缺点,包括体表面积法、药代动力学指导法、最小预期生物学效应水平法、药代动力学 - 药效学建模法、相似药物法和微剂量法。详细阐述了通过缩放因子估算人体研究最大推荐起始剂量的五个步骤。还展示了一些说明不同方法应用的实例以及应用这些方法时可能需要考虑的问题。此外,还讨论了动物给药、通过饮食给药、最大可吸收剂量、血液采样和麻醉等方面的典型注意事项。总之,本综述可为参与临床前和早期临床药物开发各阶段的研究人员预测动物等效人体剂量提供简明指南。

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