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在纳米比亚温得和克的一家转诊医院,从成人到儿科抗逆转录病毒剂量的比例幂模型在儿童中的表现。

Performance of the allometric power model in scaling from adult to paediatric antiretroviral dose in children at a Referral Hospital in Windhoek, Namibia.

机构信息

School of Pharmacy, Faculty of Health Sciences & Veterinary Medicine, University of Namibia.

出版信息

Afr Health Sci. 2022 Sep;22(3):436-441. doi: 10.4314/ahs.v22i3.47.

Abstract

BACKGROUND

World Health Organization (WHO) advocates use of weight bands in antiretroviral therapy (ART) guidelines. Allometric scaling could be a more reliable method because it uses a non-linear approach in relating dose to body weight. This study evaluates performance of the allometric ¾ power model in comparison to WHO weight band method in children receiving ART.

METHODS

Records of children receiving (ABC/3TC) + DTG were reviewed. Paediatric ABC/3TC dose was calculated from the adult dose using the allometric ¾ power model and compared to WHO weight band dose.

RESULTS

WHO weight band strategy grouped 50.6% of the children in the 25 kg category and therefore received the adult dose of ABC/3TC (600 mg/300 mg); only 1.1% received this dose with allometric scaling. Mean dose (3.8 tablets) for the WHO weight band dosing method was found to be significantly higher (p<0.0001) than for allometric scaling (1.5 tablets).

CONCLUSIONS

WHO weight bands may result in the 25 kg weight category receiving a much higher dose leading to ADRs. Using allometric scaling, we recommend a weight band strategy that could improve paediatric ABC/3TC dosing.

摘要

背景

世界卫生组织(WHO)主张在抗逆转录病毒疗法(ART)指南中使用体重带。比例法可能是一种更可靠的方法,因为它在将剂量与体重相关联时采用了非线性方法。本研究评估了比例法 ¾ 幂模型与 WHO 体重带法在接受 ART 治疗的儿童中的表现。

方法

回顾接受(ABC/3TC)+DTG 治疗的儿童记录。使用比例法 ¾ 幂模型从成人剂量计算儿科 ABC/3TC 剂量,并与 WHO 体重带剂量进行比较。

结果

WHO 体重带策略将 50.6%的儿童归入 25 公斤类别,因此接受成人剂量的 ABC/3TC(600mg/300mg);只有 1.1%的儿童接受比例法剂量。发现 WHO 体重带剂量方法的平均剂量(3.8 片)明显高于比例法(1.5 片)(p<0.0001)。

结论

WHO 体重带可能导致 25 公斤体重类别接受更高的剂量,从而导致不良反应。使用比例法,我们建议采用体重带策略,这可能会改善儿科 ABC/3TC 的剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed52/9993295/b11c329698f7/AFHS2203-0436Fig1.jpg

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