Chen Xiao, Hu Ke, Shi Hao-Zhe, Chen Liang, Zhang Yi-Jia, He Su-Mei, Zhang Cun, Wang Dong-Dong
School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy and School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Front Pharmacol. 2024 Aug 21;15:1444169. doi: 10.3389/fphar.2024.1444169. eCollection 2024.
Olanzapine is used for treating bipolar disorder (BPD); however, the optimal initial dosing regimen is unclear. The present study aimed to investigate the optimal olanzapine initial dosage in patients with BPD via model-informed precision dosing (MIPD) based on a real-world study.
Thirty-nine patients with BPD from the real-world study were collected to construct the MIPD model.
Weight, combined used quetiapine influenced olanzapine clearances in patients with BPD, where the clearance rates were 0.152:1 in patients with or without quetiapine under the same weight. We simulated olanzapine doses once a day or twice a day, of which twice a day was optimal. Without quetiapine, for twice-a-day olanzapine doses, 0.80, 0.70, and 0.60 mg/kg/day were suitable for 40- to 56-kg BPD patients, 56- to 74-kg BPD patients, and 74- to 100-kg BPD patients, respectively. With quetiapine, for twice-a-day olanzapine doses, 0.05 mg/kg/day was suitable for 40- to 100-kg BPD patients.
This study was the first to investigate the optimal olanzapine initial dosage in patients with BPD via MIPD based on a real-world study, providing clinical reference for the precision medication of olanzapine in BPD patients.
奥氮平用于治疗双相情感障碍（BPD）；然而，最佳初始给药方案尚不清楚。本研究旨在通过基于真实世界研究的模型引导精准给药（MIPD）来探究BPD患者的最佳奥氮平初始剂量。
收集来自真实世界研究的39例BPD患者以构建MIPD模型。
体重、联合使用喹硫平影响BPD患者的奥氮平清除率，在相同体重下，使用或未使用喹硫平的患者清除率之比为0.152:1。我们模拟了奥氮平每日一次或两次的给药剂量，其中每日两次为最佳。未使用喹硫平时，对于每日两次的奥氮平给药剂量，40至56千克的BPD患者、56至74千克的BPD患者以及74至100千克的BPD患者分别适合的剂量为0.80、0.70和0.60毫克/千克/天。使用喹硫平时，对于每日两次的奥氮平给药剂量，40至100千克的BPD患者适合的剂量为0.05毫克/千克/天。
本研究首次通过基于真实世界研究的MIPD探究BPD患者的最佳奥氮平初始剂量，为BPD患者奥氮平的精准用药提供临床参考。
