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Population Pharmacokinetic Modeling of Abacavir/Dolutegravir/Lamivudine to Support a Fixed-Dose Combination in Children with HIV-1.

作者信息

Chandasana Hardik, van Dijkman Sven C, Mehta Rashmi, Bush Mark, Rabie Helena, Flynn Patricia, Cressey Tim R, Acosta Edward P, Brooks Kristina M

机构信息

Clinical Pharmacology Modeling and Simulation, GSK, 1250 South Collegeville Road, Collegeville, PA, 19426, USA.

GSK, Brentford, UK.

出版信息

Infect Dis Ther. 2024 Aug;13(8):1877-1891. doi: 10.1007/s40121-024-01008-y. Epub 2024 Jul 4.


DOI:10.1007/s40121-024-01008-y
PMID:38961048
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11266315/
Abstract

INTRODUCTION: Once-daily fixed-dose combinations (FDC) containing abacavir (ABC), dolutegravir (DTG), and lamivudine (3TC) have been approved in the US for adults and children with HIV weighing ≥ 6 kg. This analysis assessed the ability of previously developed ABC, DTG, and 3TC pediatric population pharmacokinetic (PopPK) models using multiple formulations to describe and predict PK data in young children using dispersible tablet (DT) and tablet formulations of ABC/DTG/3TC FDC in the IMPAACT 2019 study. METHODS: IMPAACT 2019 was a Phase I/II study assessing the PK, safety, tolerability, and efficacy of ABC/DTG/3TC FDC in children with HIV-1. Intensive and sparse PK samples were collected over 48 weeks. Existing drug-specific pediatric PopPK models for ABC (2-compartment), DTG (1-compartment), and 3TC (1-compartment) were applied to the IMPAACT 2019 drug concentration data without re-estimation (external validation) of PopPK parameters. Drug exposures were then simulated across World Health Organization weight bands for children weighing ≥ 6 to < 40 kg for each drug and compared with pre-defined exposure target ranges. RESULTS: Goodness-of-fit and visual predictive check plots demonstrated that the previously developed pediatric PopPK models sufficiently described and predicted the data. Thus, new PopPK models describing the IMPAACT 2019 data were unnecessary. Across weight bands, the predicted geometric mean (GM) for ABC AUC ranged from 14.89 to 18.50 μgh/ml, DTG C24 ranged from 0.74 to 0.95 μg/ml, and 3TC AUC ranged from 10.50 to 13.20 μgh/ml. These exposures were well within the pre-defined target ranges set for each drug. CONCLUSION: This model-based approach leveraged existing pediatric data and models to confirm dosing of ABC/DTG/3TC FDC formulations in children with HIV-1. This analysis supports ABC/DTG/3TC FDC dosing in children weighing ≥ 6 kg.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/cc147c502c54/40121_2024_1008_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/9693bc2d622e/40121_2024_1008_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/27eef79fd07d/40121_2024_1008_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/2fe2ae741a58/40121_2024_1008_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/cc147c502c54/40121_2024_1008_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/9693bc2d622e/40121_2024_1008_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/27eef79fd07d/40121_2024_1008_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/2fe2ae741a58/40121_2024_1008_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c3/11266315/cc147c502c54/40121_2024_1008_Fig4_HTML.jpg

相似文献

[1]
Population Pharmacokinetic Modeling of Abacavir/Dolutegravir/Lamivudine to Support a Fixed-Dose Combination in Children with HIV-1.

Infect Dis Ther. 2024-8

[2]
A Model-Based Approach Supporting Abacavir/Dolutegravir/Lamivudine Fixed-Dose Combination Approval in Children Living with HIV-1.

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[3]
Pharmacokinetics, safety, and tolerability of dispersible and immediate-release abacavir, dolutegravir, and lamivudine tablets in children with HIV (IMPAACT 2019): week 24 results of an open-label, multicentre, phase 1-2 dose-confirmation study.

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[8]
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引用本文的文献

[1]
Efficacy, Safety and Tolerability of Dispersible and Immediate Release Abacavir/Dolutegravir/Lamivudine Tablets in Children With HIV: IMPAACT 2019 Week 48 Results.

Pediatr Infect Dis J. 2025-5-29

[2]
A Model-Based Approach Supporting Abacavir/Dolutegravir/Lamivudine Fixed-Dose Combination Approval in Children Living with HIV-1.

J Clin Pharmacol. 2024-9-5

本文引用的文献

[1]
Population Pharmacokinetic Modeling of Dolutegravir to Optimize Pediatric Dosing in HIV-1-Infected Infants, Children, and Adolescents.

Clin Pharmacokinet. 2023-10

[2]
Pharmacokinetics, safety, and tolerability of dispersible and immediate-release abacavir, dolutegravir, and lamivudine tablets in children with HIV (IMPAACT 2019): week 24 results of an open-label, multicentre, phase 1-2 dose-confirmation study.

Lancet HIV. 2023-8

[3]
Pharmacokinetics, safety, tolerability, and antiviral activity of dolutegravir dispersible tablets in infants and children with HIV-1 (IMPAACT P1093): results of an open-label, phase 1-2 trial.

Lancet HIV. 2022-5

[4]
Dolutegravir dosing for children with HIV weighing less than 20 kg: pharmacokinetic and safety substudies nested in the open-label, multicentre, randomised, non-inferiority ODYSSEY trial.

Lancet HIV. 2022-5

[5]
Development of Dolutegravir Single-entity and Fixed-dose Combination Formulations for Children.

Pediatr Infect Dis J. 2022-3-1

[6]
Simplified dolutegravir dosing for children with HIV weighing 20 kg or more: pharmacokinetic and safety substudies of the multicentre, randomised ODYSSEY trial.

Lancet HIV. 2020-8

[7]
Enrollment and transition challenges in the International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) network's PROMISE trial for resource-limited regions.

Clin Trials. 2020-8

[8]
Population pharmacokinetics of dolutegravir in HIV-infected treatment-naive patients.

Br J Clin Pharmacol. 2015-9

[9]
Systematic review and meta-analysis: Patient and programme impact of fixed-dose combination antiretroviral therapy.

Trop Med Int Health. 2014-3-17

[10]
Pharmacokinetics of antiretroviral drug varies with formulation in the target population of children with HIV-1.

Clin Pharmacol Ther. 2011-12-21

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