Patients with Obesity Should be Recognised as a Special Patient Population During Drug Development of Antibacterial and Antifungal Agents; A Call to Action.

Autor: van Rhee KP; Department of Clinical Pharmacy Tergooi MC, Van Riebeeckweg 212, 1213 XZ, Hilversum, The Netherlands. kp.van.rhee@stjansdal.nl.; Department of Clinical Pharmacy, St Jansdal Hospital, Wethouder Jansenlaan 90, 3844 DG, Harderwijk, The Netherlands. kp.van.rhee@stjansdal.nl.; Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands. kp.van.rhee@stjansdal.nl., Knibbe CAJ; Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.; Department of Clinical Pharmacy, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands., van der Linden PD; Department of Clinical Pharmacy Tergooi MC, Van Riebeeckweg 212, 1213 XZ, Hilversum, The Netherlands., Brüggemann RJM; Department of Pharmacy, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.; Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Clinical pharmacokinetics [Clin Pharmacokinet] 2024 Jan; Vol. 63 (1), pp. 1-12. Date of Electronic Publication: 2024 Jan 05.
DOI: 10.1007/s40262-023-01332-5
Abstrakt: Individuals with obesity are at increased risk of developing infectious diseases. Timely administration of an effective dose of an antimicrobial agent is paramount to safeguard optimal therapy. For this purpose, special patient populations at risk for altered exposure such as renal or hepatic impairment are studied during drug development. Strikingly, there is no such evaluation in individuals with obesity despite a potential influence on exposure and a global obesity prevalence of 13 %. Optimal clinical decision making in patients with obesity is impossible without prior study of the drug of interest in this population. This statement is strengthened by an evaluation of 19 antimicrobial agents that showed tremendous variability in the influence of weight on clearance. In contrast to patient with renal or hepatic impairment who are mainly at risk of overexposure, individuals with obesity can be at risk of both under- and overexposure. Gaining knowledge on the influence of body weight on clearance during early phases of drug development may allow for optimisation of other phases of research, potentially increasing success rate of the drug, and can provide clinicians with vital information as soon as the drug reaches the market. Antimicrobial therapy should be tailored to obesity-related (patho)physiological changes and to reach this goal, obese individuals should be studied during drug development.
(© 2024. The Author(s).)
Databáze: MEDLINE
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