Golhen Klervi, Buettcher Michael, Huwyler Jörg, van den Anker John, Gotta Verena, Dao Kim, Rothuizen Laura E, Kobylinski Kevin, Pfister Marc
Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland.
Pediatric Infectious Diseases, Children's Hospital of Central Switzerland (KidZ), Lucerne Cantonal Hospital, 6000 Luzern, Switzerland.
Pharmaceutics. 2024 Sep 7;16(9):1186. doi: 10.3390/pharmaceutics16091186.
The antiparasitic drug ivermectin is approved for persons > 15 kg in the US and EU. A pharmacometric (PMX) population model with clinical PK data was developed (i) to characterize the effect of the patient-friendly ivermectin formulation CHILD-IVITAB on the absorption process and (ii) to evaluate dosing for studies in children < 15 kg. Simulations were performed to identify dosing with CHILD-IVITAB associated with similar exposure coverage in children ≥ 15 kg and < 15 kg as observed in adults receiving the reference formulation STROMECTOL. A total of 448 ivermectin concentrations were available from 16 healthy adults. The absorption rate constant was 2.41 h (CV 19%) for CHILD-IVITAB vs. 1.56 h (CV 43%) for STROMECTOL. Simulations indicated that 250 µg/kg of CHILD-IVITAB is associated with exposure coverage in children < 15 kg consistent with that observed in children ≥ 15 kg and adults receiving 200 µg/kg of STROMECTOL. Performed analysis confirmed that CHILD-IVITAB is associated with faster and more controlled absorption than STROMECTOL. Simulations indicate that 250 µg/kg of CHILD-IVITAB achieves equivalent ivermectin exposure coverage in children < 15 kg as seen in children ≥ 15 kg and adults.
抗寄生虫药物伊维菌素在美国和欧盟被批准用于体重超过15公斤的人群。利用临床药代动力学(PK)数据建立了一个药代计量学(PMX)群体模型,(i)以表征患者友好型伊维菌素制剂CHILD-IVITAB对吸收过程的影响,以及(ii)评估15公斤以下儿童研究的给药剂量。进行模拟以确定CHILD-IVITAB的给药剂量,该剂量在15公斤及以上和15公斤以下儿童中的暴露覆盖情况与接受参比制剂STROMECTOL的成年人中观察到的情况相似。从16名健康成年人中总共获得了448个伊维菌素浓度数据。CHILD-IVITAB的吸收速率常数为2.41小时(变异系数19%),而STROMECTOL为1.56小时(变异系数43%)。模拟表明,250微克/公斤的CHILD-IVITAB在15公斤以下儿童中的暴露覆盖情况与15公斤及以上儿童和接受200微克/公斤STROMECTOL的成年人中观察到的情况一致。进行的分析证实,与STROMECTOL相比,CHILD-IVITAB的吸收更快且更可控。模拟表明,250微克/公斤的CHILD-IVITAB在15公斤以下儿童中实现的伊维菌素暴露覆盖情况与15公斤及以上儿童和成年人中的情况相当。