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基于生理的司美格鲁肽在健康和肥胖体重儿童和青少年中的药代动力学模型。

Physiologically based pharmacokinetic modelling of semaglutide in children and adolescents with healthy and obese body weights.

机构信息

Laboratory of Molecular Modeling & QSAR (ModMolQSAR), Faculty of Pharmacy, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

BIODATA Computing Services & Consulting, Rio de Janeiro, Brazil.

出版信息

Br J Clin Pharmacol. 2023 Oct;89(10):3175-3194. doi: 10.1111/bcp.15816. Epub 2023 Jul 2.

Abstract

AIMS

To develop paediatric physiologically based pharmacokinetic modelling (PBPK) models of semaglutide to estimate the pharmacokinetic profile for subcutaneous injections in children and adolescents with healthy and obese body weights.

METHODS

Pharmacokinetic modelling and simulations of semaglutide subcutaneous injections were performed using the Transdermal Compartmental Absorption & Transit model implemented in GastroPlus v.9.5 modules. A PBPK model of semaglutide was developed and verified in the adult population, by comparing the simulated plasma exposure with the observed data, and further scaled to the paediatric populations with normal and obese body weight.

RESULTS

The semaglutide PBPK model was successfully developed in adults and scaled to the paediatric population. Our paediatric PBPK simulations indicated a significant increase in maximum plasma concentrations for the 10-14 years' paediatric population with healthy body weights, which was higher than the observed values in adults at the reference dose. Since gastrointestinal adverse events are related to increased semaglutide concentrations, peak concentrations outside the target range may represent a safety risk for this paediatric age group. Besides, paediatric PBPK models indicated that body weight was inversely related to semaglutide maximum plasma concentration, corroborating the consensus on the influence of body weight on semaglutide PK in adults.

CONCLUSION

Paediatric PBPK was successfully achieved using a top-down approach and drug-related parameters. The development of unprecedented PBPK models will support paediatric clinical therapy for applying aid-safe dosing regimens for the paediatric population in diabetes treatment.

摘要

目的

开发司美格鲁肽儿科生理药代动力学模型(PBPK),以估计健康和肥胖体重的儿童和青少年皮下注射的药代动力学特征。

方法

使用 GastroPlus v.9.5 模块中的经皮房室吸收和转运模型,对司美格鲁肽皮下注射的药代动力学模型和模拟进行了研究。通过比较模拟血浆暴露与观察数据,在成年人群中开发和验证了司美格鲁肽的 PBPK 模型,并进一步扩展到正常和肥胖体重的儿科人群。

结果

司美格鲁肽 PBPK 模型在成年人群中成功建立,并扩展到儿科人群。我们的儿科 PBPK 模拟表明,健康体重的 10-14 岁儿科人群的最大血浆浓度显著增加,高于成人参考剂量的观察值。由于胃肠道不良事件与司美格鲁肽浓度增加有关,因此超出目标范围的峰值浓度可能代表该儿科年龄组的安全风险。此外,儿科 PBPK 模型表明体重与司美格鲁肽最大血浆浓度呈反比,这与成人中体重对司美格鲁肽 PK 的影响共识一致。

结论

使用自上而下的方法和药物相关参数成功实现了儿科 PBPK。前所未有的 PBPK 模型的开发将支持儿科临床治疗,为糖尿病治疗中的儿科人群应用辅助安全剂量方案。

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