College of Pharmacy, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea.
Department of Herbal Medicine Resource, Kangwon National University, 346 Hwangjo-gil, Dogye-eup, Samcheok-si, Gangwon-do 25949, Republic of Korea.
Mol Pharm. 2020 Apr 6;17(4):1079-1089. doi: 10.1021/acs.molpharmaceut.9b00964. Epub 2020 Feb 24.
Ticagrelor (TCG) has been used as an antiplatelet agent for acute coronary syndrome patients. The aim of this research was to establish a population pharmacokinetic/pharmacodynamic (PK/PD) model of TCG and to apply the model for predicting the PD response of the TCG-loaded self-microemulsifying drug delivery system (TCG-SME) in rats. Pure TCG and TCG-SME (2, 5, and 10 mg/kg of TCG) were orally administered to male Sprague-Dawley rats. Plasma samples were collected at scheduled time-points and then analyzed for TCG plasma concentrations and antiplatelet effects. The inhibition of platelet aggregation of TCG was measured as a PD response. The PK profiles of pure TCG and TCG-SME could be well-explained with a two-compartment PK model. The accuracy of the PK model was assessed with a goodness-of-fit plot and conditional weight residual error (CWRES). Also, the visual predictive check was investigated based on the predictions. A population PK/PD model for pure TCG was established as an indirect response model linked to the two-compartment PK model of pure TCG. The PK/PD model proposed a suitable fitting to link the plasma concentration of TCG simultaneously with platelet aggregation. Based on the PK data of TCG-SME, as well as the established PK/PD model of pure TCG, the PD profiles of TCG-SME were simulated. TCG-SME was more effective in inducing the antiplatelet effect than pure TCG at equivalent doses of TCG. The accuracy of the simulation was verified by comparing the simulated PD profile with the profile observed in rats. The observations were close to the model simulations. In addition, the values of CWRES were almost within ±2. In conclusion, the PK/PD modeling approach can provide a way for predicting mathematically the PD responses from PK profiles of other TCG formulations and a conceptual prediction for future clinical assessment.
替格瑞洛(TCG)已被用作急性冠脉综合征患者的抗血小板药物。本研究旨在建立 TCG 的群体药代动力学/药效动力学(PK/PD)模型,并将该模型应用于预测 TCG 载自微乳化给药系统(TCG-SME)在大鼠体内的 PD 反应。雄性 Sprague-Dawley 大鼠分别口服给予纯 TCG 和 TCG-SME(TCG 剂量为 2、5 和 10mg/kg)。在预定时间点采集血浆样本,然后分析 TCG 血浆浓度和抗血小板作用。TCG 对血小板聚集的抑制作用作为 PD 反应进行测量。纯 TCG 和 TCG-SME 的 PK 谱可以用两室 PK 模型很好地解释。通过拟合优度图和条件权重残差(CWRES)评估 PK 模型的准确性。此外,还基于预测进行了可视化预测检查。建立了纯 TCG 的群体 PK/PD 模型,作为与纯 TCG 的两室 PK 模型相关的间接反应模型。所提出的 PK/PD 模型提出了一种合适的拟合方法,可同时将 TCG 的血浆浓度与血小板聚集联系起来。基于 TCG-SME 的 PK 数据以及纯 TCG 的建立的 PK/PD 模型,模拟了 TCG-SME 的 PD 曲线。在等效 TCG 剂量下,TCG-SME 比纯 TCG 更有效地诱导抗血小板作用。通过将模拟的 PD 曲线与大鼠体内观察到的曲线进行比较,验证了模拟的准确性。观察结果与模型模拟结果接近。此外,CWRES 的值几乎在±2 以内。总之,PK/PD 建模方法可以为预测其他 TCG 制剂的 PK 曲线的 PD 反应提供一种数学方法,并为未来的临床评估提供概念预测。