A population pharmacokinetic model taking into account protein binding for the sustained-release granule formulation of valproic acid in children with epilepsy
| Autor: | Vincent Jullien, Catherine Chiron, Elisabeth Rey, Stéphanie Chhun, Olivier Dulac, Christelle Rodrigues, Gérard Pons |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Adolescent Population Pharmacology 030226 pharmacology & pharmacy Models Biological 03 medical and health sciences Epilepsy 0302 clinical medicine Pharmacokinetics medicine Humans Pharmacology (medical) Trough Concentration education Child education.field_of_study Valproic Acid Chemistry Granule (cell biology) Body Weight Infant General Medicine medicine.disease NONMEM Pharmacodynamics Child Preschool Delayed-Action Preparations Anticonvulsants Female Monte Carlo Method 030217 neurology & neurosurgery medicine.drug Protein Binding |
| Zdroj: | European journal of clinical pharmacology. 74(6) |
| ISSN: | 1432-1041 |
| Popis: | The objective of this work was to develop a population pharmacokinetic model for a prolonged-release granule formulation of valproic acid (VPA) in children with epilepsy and to determine the doses providing a VPA trough concentration (Ctrough) within the target range (50–100 mg/L). Ninety-eight children (1–17.6 years, 325 plasma samples) were included in the study. The model was built with NONMEM 7.3. The probability to obtain Ctrough between 50 and 100 mg/L was determined by the Monte Carlo simulations for doses of 20, 30, 40, and 60 mg/kg/day and body weights between 10 and 70 kg. A one compartment model, with first-order absorption and flip-flop parameterization and linear elimination, but taking protein binding into account, was used to describe the data. Typical values for unbound VPA clearance and distribution volume were 6.24 L/h/70 kg and 130 L/h/70 kg respectively. Both parameters were related to body weight via allometric models. The highest probability to obtain a Ctrough within the target range for 10-kg children was obtained with a 40 mg/kg daily dose, whereas daily doses of 30 and 20 mg/kg were found appropriate for 20 to 30- and ≥ 40-kg children respectively. However, for these same doses, the exposure to unbound VPA could differ by 40%. If the present study supports the current dose recommendations of 20–30 mg/kg/day, except for children under 20 kg, who may need higher doses, it also highlights the need for further research on the pharmacokinetics/pharmacodynamic profile of unbound VPA. |
| Databáze: | OpenAIRE |
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