Ezuruike Udoamaka, Curry Liam, Hatley Oliver, Gardner Iain
Certara UK Limited (Simcyp Division), Sheffield, UK.
Br J Clin Pharmacol. 2025 Apr;91(4):1016-1030. doi: 10.1111/bcp.15982. Epub 2024 Jan 16.
The aim of this study is to demonstrate the use of PBPK modelling to explore the impact of ethnic differences on drug PK.
A PBPK model developed for lansoprazole was used to predict the clinical PK of lansoprazole in Japanese subjects by incorporating the physiological parameters of a Japanese population into the model. Further verification of the developed Japanese population with clinical studies involving eight other CYP substrates-omeprazole, ticlopidine, alprazolam, midazolam, nifedipine, cinacalcet, paroxetine and dextromethorphan-was also carried out.
The PK of lansoprazole in both Caucasian and Japanese subjects was well predicted by the model as the observed data were within the 5th and 95th percentiles across all the clinical studies. In age- and sex-matched simulations in both the Caucasian and Japanese populations, the predicted PK (mean ± SD) of a single oral dose of 30-mg lansoprazole was higher in the Japanese population in all cases, with more than twofold higher AUC of 5.98 ± 6.43 mg/L.h (95% CI: 4.72, 7.24) vs. 2.46 ± 2.45 mg/L.h (95% CI: 1.98, 2.94) in one scenario. In addition, in two out of the nine clinical DDIs of lansoprazole and the additional CYP substrates simulated using the Japanese population, the predicted DDI in Japanese was more than 1.25-fold that in Caucasians, indicating an increased DDI liability.
By accounting for various physiological parameters that characterize a population in a PBPK model, the impact of the different identified interethnic differences on the drug's PK can be explored, which can inform the adoption of drugs from one region to another.
本研究旨在证明使用生理药代动力学(PBPK)模型来探讨种族差异对药物药代动力学(PK)的影响。
通过将日本人群的生理参数纳入为兰索拉唑开发的PBPK模型中,来预测兰索拉唑在日本受试者中的临床PK。还使用涉及其他八种细胞色素P450(CYP)底物(奥美拉唑、噻氯匹定、阿普唑仑、咪达唑仑、硝苯地平、西那卡塞、帕罗西汀和右美沙芬)的临床研究对所开发的日本人群模型进行了进一步验证。
该模型很好地预测了白种人和日本受试者中兰索拉唑的PK,因为在所有临床研究中观察到的数据均在第5和第95百分位数范围内。在白种人和日本人群年龄和性别匹配的模拟中,单次口服30mg兰索拉唑的预测PK(平均值±标准差)在所有情况下日本人群均较高,在一种情况下,曲线下面积(AUC)为5.98±6.43mg/L·h(95%置信区间:4.72,7.24),是2.46±2.45mg/L·h(95%置信区间:1.98,2.94)的两倍多。此外,在使用日本人群模拟的兰索拉唑与其他CYP底物的九种临床药物相互作用(DDI)中的两种中,预测的日本人群中的DDI比白种人高出1.25倍以上,表明药物相互作用风险增加。
通过在PBPK模型中考虑表征人群的各种生理参数,可以探索已确定的不同种族间差异对药物PK的影响,这可为药物从一个地区转移到另一个地区的应用提供参考。