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大小和成熟度函数在儿科患者群体药代动力学建模中的应用。

Application of Size and Maturation Functions to Population Pharmacokinetic Modeling of Pediatric Patients.

作者信息

Back Hyun-Moon, Lee Jong Bong, Han Nayoung, Goo Sungwoo, Jung Eben, Kim Junyeong, Song Byungjeong, An Sook Hee, Kim Jung Tae, Rhie Sandy Jeong, Ree Yoon Sun, Chae Jung-Woo, Kim JaeWoo, Yun Hwi-Yeol

机构信息

Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA.

College of Pharmacy, Seoul National University, Gwanak-ro 1, Gwanakgu, Seoul 08826, Korea.

出版信息

Pharmaceutics. 2019 Jun 3;11(6):259. doi: 10.3390/pharmaceutics11060259.

Abstract

Traditionally, dosage for pediatric patients has been optimized using simple weight-scaled methods, but these methods do not always meet the requirements of children. To overcome this discrepancy, population pharmacokinetic (PK) modeling of size and maturation functions has been proposed. The main objective of the present study was to evaluate a new modeling method for pediatric patients using clinical data from three different clinical studies. To develop the PK models, a nonlinear mixed effect modeling method was employed, and to explore PK differences in pediatric patients, size with allometric and maturation with Michaelis-Menten type functions were evaluated. Goodness of fit plots, visual predictive check and bootstrap were used for model evaluation. Single application of size scaling to PK parameters was statistically significant for the over one year old group. On the other hand, simultaneous use of size and maturation functions was statistically significant for infants younger than one year old. In conclusion, population PK modeling for pediatric patients was successfully performed using clinical data. Size and maturation functions were applied according to established criteria, and single use of size function was applicable for over one year ages, while size and maturation functions were more effective for PK analysis of neonates and infants.

摘要

传统上,儿科患者的剂量是使用简单的体重缩放方法进行优化的,但这些方法并不总是能满足儿童的需求。为了克服这种差异,有人提出了基于大小和成熟度函数的群体药代动力学(PK)建模方法。本研究的主要目的是使用来自三项不同临床研究的临床数据评估一种针对儿科患者的新建模方法。为了建立PK模型,采用了非线性混合效应建模方法,并且为了探索儿科患者的PK差异,对具有异速生长的大小和具有米氏类型函数的成熟度进行了评估。使用拟合优度图、视觉预测检查和自抽样法进行模型评估。对于一岁以上的儿童组,将大小缩放单独应用于PK参数具有统计学意义。另一方面,对于一岁以下的婴儿,同时使用大小和成熟度函数具有统计学意义。总之,利用临床数据成功地对儿科患者进行了群体PK建模。根据既定标准应用大小和成熟度函数,大小函数的单独使用适用于一岁以上的儿童,而大小和成熟度函数对新生儿和婴儿的PK分析更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7808/6630378/b1dff9d9b158/pharmaceutics-11-00259-g001.jpg

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