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一种加速药物研发的预测方法。

A forecasting approach to accelerate drug development.

作者信息

Hunt C A, Guzy S, Weiner D L

机构信息

University of California, San Francisco 94143-0446, USA.

出版信息

Stat Med. 1998;17(15-16):1725-40; discussion 1741-3. doi: 10.1002/(sici)1097-0258(19980815/30)17:15/16<1725::aid-sim974>3.0.co;2-2.

Abstract

The clinical phase of drug development should be concluded sooner and at a lower cost if primarily only the pivotal and supportive studies were to be conducted. Such improved efficiency requires development of a decision support system that delivers five new capabilities: (i) it enables one to predict a result of a clinical study and to identify those studies that are expected to have an acceptable probability of success; (ii) it will allow one to optimally utilize available pharmacokinetic and pharmacodynamic (PK/PD) data and improve its predictive capability as more data become available; (iii) it will enable one to project useful population results, not just mean results; (iv) predictions will be accompanied by a measure of reliability; and (v) expected initial clinical results will be predictable from animal and related drug class data. With such a tool population targets could be specified very early in the drug development programme, challenged, and then rationally revised at each step during the development process. This report describes progress in developing and testing a clinical trials Forecaster, a prototype for such a system. The Forecaster generates estimates of the joint density for a population of combined PK/PD parameters. That population then serves as a surrogate for the population of individuals. When the resulting joint density is sampled, the obtained sets of parameters may be used to generate data that is statistically indistinguishable from the original experimental data. Such simulated data can be used to validate assumptions, and make inferences on specified population targets that are accompanied by a measure of prediction reliability. We demonstrate use of the forecaster by employing N = 22 PK/PD parameter sets for an orally administered analgesic.

摘要

如果主要仅进行关键和支持性研究,药物开发的临床阶段应能更快且以更低成本完成。这种效率的提高需要开发一种决策支持系统,该系统具备五项新能力:(i)它能使人们预测临床研究的结果,并识别那些预期有可接受成功概率的研究;(ii)随着更多数据可用,它将允许人们最佳地利用现有的药代动力学和药效学(PK/PD)数据,并提高其预测能力;(iii)它将使人们能够预测有用的总体结果,而不仅仅是平均结果;(iv)预测将伴有可靠性度量;(v)预期的初始临床结果将可从动物和相关药物类别数据中预测出来。借助这样一种工具,在药物开发计划的早期就能明确总体目标,对其进行挑战,然后在开发过程的每个步骤进行合理修订。本报告描述了开发和测试临床试验预测器(这样一个系统的原型)的进展。该预测器生成一组组合的PK/PD参数的总体联合密度估计值。然后该总体作为个体总体的替代。对得到的联合密度进行抽样时,所获得的参数集可用于生成与原始实验数据在统计上无法区分的数据。这种模拟数据可用于验证假设,并对伴有预测可靠性度量的指定总体目标进行推断。我们通过使用N = 22个口服镇痛药的PK/PD参数集来演示预测器的使用。

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