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Azzopardi N, Longuet H, Ternant D, Thibault G, Gouilleux-Gruart V, Lebranchu Y, Büchler M, Gatault P, Paintaud G. Relationship Between Antithymocyte Globulin Concentrations and Lymphocyte Sub-Populations in Kidney Transplant Patients. Clin Pharmacokinet 2021; 61:111-122. [PMID: 34292526 DOI: 10.1007/s40262-021-01053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Rabbit antithymocyte globulins (rATGs) are polyclonal antibodies used to prevent acute cellular rejection in kidney transplantation. Their dosing remains largely empirical and the question of an individualized dose is still unresolved. METHODS Data from a prospective study in 17 kidney transplant patients were used to develop a model describing the dose-concentration-response relationship of rATG with T-lymphocyte subpopulation counts over time. The model was validated using an independent cohort of kidney transplant patients treated by rATG in the same center. RESULTS Pharmacokinetics of rATG was described using a two-compartment model integrating a third compartment and a target-mediated elimination for active rATG. The kinetics of CD3+, CD4+, CD8+, and CD3-CD56+ cell counts over time were described by a pharmacokinetic-pharmacodynamic model with transit compartments, integrating both CD3-CD56+-independent and CD3-CD56+-dependent rATG-mediated lymphocyte depletion, and a positive feedback. Elimination of rATG was influenced by age and body surface area, while its distribution was also influenced by body surface area. CD3+ proliferation rate decreased with age and CD3-CD56+-mediated elimination was influenced by the V158F-FCGR3A polymorphism. Binary efficacy and tolerance endpoints were defined as a CD3+ count < 20 mm-3 for at least 7 days and a CD4+ count > 200 mm-3 at 1 year, respectively. Simulations showed that increasing or decreasing the standard 6-mg/kg dose will impact both tolerance and efficacy, while a dose decrease may be beneficial in elderly patients. CONCLUSIONS Our results can be used to design prospective clinical trials testing dose individualization based on patients' characteristics. CLINICAL TRIAL REGISTRATION Eudract No. 2009-012673-35.
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Affiliation(s)
| | - Hélène Longuet
- Department of Nephrology and Clinical Immunology, CHRU de Tours, Tours, France
| | - David Ternant
- University of Tours, EA4245 T2I, Tours, France. .,Department of Medical Pharmacology, CHRU de Tours, 37044, Tours, France.
| | - Gilles Thibault
- University of Tours, EA7501 GICC, Tours, France.,Laboratory of Immunology, CHRU de Tours, Tours, France
| | - Valérie Gouilleux-Gruart
- University of Tours, EA7501 GICC, Tours, France.,Laboratory of Immunology, CHRU de Tours, Tours, France
| | | | - Matthias Büchler
- Department of Nephrology and Clinical Immunology, CHRU de Tours, Tours, France.,University of Tours, EA4245 T2I, Tours, France
| | - Philippe Gatault
- Department of Nephrology and Clinical Immunology, CHRU de Tours, Tours, France.,University of Tours, EA4245 T2I, Tours, France
| | - Gilles Paintaud
- University of Tours, EA4245 T2I, Tours, France.,Department of Medical Pharmacology, CHRU de Tours, 37044, Tours, France
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Jaworowicz D, Bihorel S, Zajic S, Stoch SA, Humphrey R, McCrea JB, Stone JA. Population Pharmacokinetic Analysis of the Cathepsin K Inhibitor Odanacatib: Insights Into Intrinsic and Extrinsic Factor Effects on Exposure in Postmenopausal and Elderly Women. J Clin Pharmacol 2020; 60:1107-1123. [PMID: 32302427 DOI: 10.1002/jcph.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/21/2020] [Indexed: 11/07/2022]
Abstract
This analysis developed a population pharmacokinetic (PK) model for odanacatib, characterized demographic and concomitant medication covariates effect, and provided odanacatib exposure estimates for subjects in phase 2/3 studies. Data from multiple phase 1 (P005, P025, and P014), phase 2b (P004 and P022), and phase 3 (Long-Term Odanacatib Fracture Trial; P018) studies were pooled to create a data set of 1280 postmenopausal women aged 45 to 91 years (102 from phase 1, 514 from phase 2b, and 664 from phase 3) who received weekly oral odanacatib doses ranging from 3 to 100 mg. A 1-compartment model with first-order absorption, dose-dependent relative bioavailability (F1), and first-order elimination best described odanacatib PK. F1 decreased from the 100% reference bioavailability for a 3-mg oral dose to 24.5% for a 100-mg dose. Eight statistically significant covariates were included in the final PK model: body weight, age, race, and concomitant cytochrome P450 (CYP)3A inhibitors on apparent clearance; body weight on apparent central volume of distribution; and concomitant hydrochlorothiazide, high-fat breakfast, and a study effect on F1. All fixed- and random-effects parameters were estimated with good precision (%standard error of the mean ≤29.5%). This population PK analysis provides insights into intrinsic- and extrinsic-factor effects on odanacatib exposure in postmenopausal and elderly women with osteoporosis. The magnitude of the intrinsic-factor effects was generally modest (odanacatib exposure geometric mean ratios, 0.80-1.21) even in subjects aged >80 years, or in subsets with multiple combinations of factors.
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Affiliation(s)
- David Jaworowicz
- Cognigen Corporation (a SimulationsPlus Company), Buffalo, New York, USA
| | - Sébastien Bihorel
- Cognigen Corporation (a SimulationsPlus Company), Buffalo, New York, USA
| | | | | | - Rebecca Humphrey
- Cognigen Corporation (a SimulationsPlus Company), Buffalo, New York, USA
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Li F, Li H, Zhai Q, Li F, Wu T, Sha X, Zhang B, Yang W, Lu Z, Tao H. A new vaccine targeting RANKL, prepared by incorporation of an unnatural Amino acid into RANKL, prevents OVX-induced bone loss in mice. Biochem Biophys Res Commun 2018; 499:648-654. [DOI: 10.1016/j.bbrc.2018.03.205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 03/27/2018] [Indexed: 01/02/2023]
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Fan CH, Lin CY, Liu HL, Yeh CK. Ultrasound targeted CNS gene delivery for Parkinson's disease treatment. J Control Release 2017; 261:246-262. [DOI: 10.1016/j.jconrel.2017.07.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/05/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
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Higgs JT, Jarboe JS, Lee JH, Chanda D, Lee CM, Deivanayagam C, Ponnazhagan S. Variants of Osteoprotegerin Lacking TRAIL Binding for Therapeutic Bone Remodeling in Osteolytic Malignancies. Mol Cancer Res 2015; 13:819-27. [PMID: 25636966 DOI: 10.1158/1541-7786.mcr-14-0492] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 01/18/2015] [Indexed: 12/15/2022]
Abstract
UNLABELLED Osteolytic bone damage is a major cause of morbidity in several metastatic pathologies. Current therapies using bisphosphonates provide modest improvement, but cytotoxic side effects still occur prompting the need to develop more effective therapies to target aggressive osteoclastogenesis. Increased levels of receptor activator of NF-κB ligand (TNFSF11/RANKL), leading to RANKL-RANK signaling, remain the key axis for osteoclast activation and bone resorption. Osteoprotegerin (TNFRSF11B/OPG), a decoy receptor for RANKL, is significantly decreased in patients who present with bone lesions. Despite its potential in inhibiting osteoclast activation, OPG also binds to TNF-related apoptosis-inducing ligand (TNFSF10/TRAIL), making tumor cells resistant to apoptosis. Toward uncoupling the events of TRAIL binding of OPG and to improve its utility for bone remodeling without inducing tumor resistance to apoptosis, OPG mutants were developed by structural homology modeling based on interactive domain identification and by superimposing models of OPG, TRAIL, and its receptor DR5 (TNFRSF10B) to identify regions of OPG for rational design. The OPG mutants were purified and extensively characterized for their ability to decrease osteoclast damage without affecting tumor apoptosis pathway both in vitro and in vivo, confirming their potential in bone remodeling following cancer-induced osteolytic damage. IMPLICATIONS OPG variants were developed that lack TRAIL binding, yet retain RANKL binding and suggest new possibilities for therapeutic targeting in osteolytic malignancies.
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Affiliation(s)
- Jerome T Higgs
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - John S Jarboe
- Department of Biochemistry, The University of Alabama at Birmingham, Birmingham, Alabama. Department of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Joo Hyoung Lee
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Diptiman Chanda
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Carnellia M Lee
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Champion Deivanayagam
- Department of Vision Sciences, The University of Alabama at Birmingham, Birmingham, Alabama
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Jin Y, Bies R, Gastonguay MR, Wang Y, Stockbridge N, Gobburu J, Madabushi R. Predicted impact of various clinical practice strategies on cardiovascular risk for the treatment of hypertension: a clinical trial simulation study. J Pharmacokinet Pharmacodyn 2014; 41:693-704. [PMID: 25326066 DOI: 10.1007/s10928-014-9394-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 10/08/2014] [Indexed: 11/24/2022]
Abstract
Hypertension control rate in the US is low with the current clinical practice (JNC 7) and cardiovascular disease (CVD) remain is the leading cause of morbidity and mortality. A 6-month clinical trial simulation case study testing different virtual clinical practice strategies was performed in an attempt to increase the control rate. The CVD risk was calculated using the Framingham CVD risk model at baseline and 6 months post-treatment. The estimated CVD events for the baseline patient sample without any treatment was 998 (95% CI: 967-1,026) over 6 months in 100,000 patients. Treating these patients for 6 months with current clinical practice, high dose strategy, high dose with low target BP strategy resulted in a reduction in CVD events of 191(95% CI: 169-205), 284 (95% CI: 261-305), and 353 (95% CI: 331-375), respectively. Hence the two alternative strategies resulted in an increase in treatment effect by 49% (95%CI: 44-59%) and 85% (95%CI: 79-99%), respectively. The increased safety with the current low dose strategy may potentially be offset by increased CVD risk in the time necessary to control hypertension.
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Affiliation(s)
- Yuyan Jin
- Clinical Pharmacology, Roche Innovation Centre Shanghai, F. Hoffmann-La Roche Ltd., Shanghai, 201203, China
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Kagan L. Pharmacokinetic Modeling of the Subcutaneous Absorption of Therapeutic Proteins. Drug Metab Dispos 2014; 42:1890-905. [DOI: 10.1124/dmd.114.059121] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Hasegawa C, Ohno T, Umemura T, Honda N, Ohyama M, Nagase S, Small M, Deacon S, Ogawa M, Ieiri I. Population pharmacokinetic and pharmacodynamic modeling of different formulations of ONO-5334, cathepsin K inhibitor, in Caucasian and Japanese postmenopausal females. J Clin Pharmacol 2013; 54:23-34. [PMID: 24115072 DOI: 10.1002/jcph.186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 09/14/2013] [Indexed: 12/27/2022]
Abstract
ONO-5334, a selective inhibitor of cathepsin K, is a potential new treatment for osteoporosis. The objectives of this study were to (1) develop population pharmacokinetic-pharmacodynamic (PK-PD) models for ONO-5334 using dose-ascending data from healthy postmenopausal females, (2) examine comparability of PK and/or PD profile between Caucasian and Japanese, and (3) compare PK-PD profile between immediate release tablet (IRT) and sustained release tablet (SRT). The population PK-PD models were developed for each formulation for post-dose levels of bone resorption markers (serum CTX and NTX). The data were provided from 4 phase 1 studies with total of 201 Caucasian and 94 Japanese subjects. Plasma concentrations of ONO-5334 and bone resorption markers were thoroughly evaluated in those studies. An indirect response model described relationships between bone resorption markers and plasma concentrations of ONO-5334. There was no significant difference in PK and pharmacodynamic potency (IC50 ) between Caucasian and Japanese. Based on the developed model, serum CTX and NTX after administration of ONO-5334 IRT or SRT were simulated, and the results showed that ONO-5334 SRT would provide comparable PD effect on bone resorption markers with lower dose relative to IRT.
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Affiliation(s)
- Chihiro Hasegawa
- Pharmacokinetic Research Laboratories, Ono Pharmaceutical Co., Ltd., Ibaraki, Japan; Department of Clinical Pharmacokinetics, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
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Forsyth R, Thuy Vu, Salorio C, Christensen J, Holford N. Review: Efficient Rehabilitation Trial Designs Using Disease Progress Modeling: A Pediatric Traumatic Brain Injury Example. Neurorehabil Neural Repair 2009; 24:225-34. [DOI: 10.1177/1545968309354534] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The identification of possible treatment effects against a background of spontaneous recovery is a major challenge to the successful completion of randomized clinical trials (RCTs) in rehabilitation research. Conventional trial outcomes such as the differences between group means of an outcome measure at a fixed time point are inefficient to an extent that is a major problem, particularly for exploratory studies seeking preliminary evidence of efficacy. Objective . To quantitate gains in study power over conventional fixed-end-point designs by using parametric end points derived from the modeling of the time course of recovery after brain injury. Methods. Nonlinear mixed effects (NLME) modeling of the recovery trajectories of 103 children rehabilitating after traumatic brain injury (TBI) as reflected in serial WeeFIM scores was performed. Pseudoreplicate data sets were generated replicating the statistical characteristics of the original data set, and these formed the basis of clinical trial simulations to derive robust estimates of study power. Results. Parametric end points derived from modeling of recovery improve study power (and reduce necessary sample size) by up to 5 times in this example. Conclusions. Parametric end points derived from models of recovery trajectories offer an efficient alternative design for exploratory clinical studies of rehabilitation interventions.
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Affiliation(s)
- Rob Forsyth
- Institute of Neuroscience, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom,
| | - Thuy Vu
- University of Auckland, Auckland, New Zealand
| | - Cynthia Salorio
- Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James Christensen
- Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Miyaji Y, Kurihara A, Kamiyama E, Shiiki T, Kawai K, Okazaki O. Pharmacokinetics and disposition of recombinant human osteoprotegerin (rhOPG) after intravenous administration in female fischer rats. Xenobiotica 2009; 39:113-24. [DOI: 10.1080/00498250802590745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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