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Ait-Chikh C, Page G, Thoreau V. Physiologically-based pharmacokinetic models to predict drug exposure during pregnancy. ANNALES PHARMACEUTIQUES FRANÇAISES 2024; 82:236-242. [PMID: 37739215 DOI: 10.1016/j.pharma.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/24/2023]
Abstract
As pregnant women are constantly exposed to drugs during pregnancy, either to treat long-term conditions or acute illnesses, drug safety is a major concern for the fetus and the mother. Clinical trials are rarely made in this population due to strict regulation and ethical reasons. However, drug pharmacokinetic (PK) parameters vary during pregnancy with an increase in distribution volume, renal clearance and more. In addition, the fetal distribution should be evaluated with the importance of placental diffusion, both active and passive. Therefore, there is a recent interest in the use of physiologically-based pharmacokinetic (PBPK) modeling to characterize these changes and complete the sparse data available on drug PK during pregnancy. Indeed, PBPK models integrate drug physicochemical and physiological parameters corresponding to each compartment of the body to estimate drug concentrations. This review establishes an overview on the current use of PBPK models in drug dosage determination for the pregnant woman, fetal exposure and drug interactions in the fetal compartment.
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Affiliation(s)
- Celia Ait-Chikh
- Faculté de médecine et pharmacie, université de Poitiers, UFR médecine et pharmacie, bâtiment D1, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France.
| | - Guylène Page
- Faculté de médecine et pharmacie, université de Poitiers, UFR médecine et pharmacie, bâtiment D1, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France; Neurovascular Unit and Cognitive Disorders (NEUVACOD), pôle Biologie santé, université de Poitiers, Poitiers, France
| | - Vincent Thoreau
- Faculté de médecine et pharmacie, université de Poitiers, UFR médecine et pharmacie, bâtiment D1, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France; Neurovascular Unit and Cognitive Disorders (NEUVACOD), pôle Biologie santé, université de Poitiers, Poitiers, France
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Zhang M, Jin Y, Li W, He C, Di X, Duan Y, Chen L, Wang Z. Quantitation of levetiracetam concentrations in plasma and saliva samples by ultra-performance liquid chromatography-tandem mass spectrometry: Application to therapeutic drug monitoring for pregnant women with epilepsy. Biomed Chromatogr 2024; 38:e5777. [PMID: 37990827 DOI: 10.1002/bmc.5777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
Although levetiracetam (LEV) has favorable linear pharmacokinetic properties, therapeutic drug monitoring (TDM) is necessary for pregnant women with epilepsy. This study aims to build a simple, reliable, and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for determining LEV concentrations in plasma and saliva samples, to support the routine TDM of LEV in Chinese pregnant women with epilepsy. The stable isotope-labeled LEV-d6 was used as the internal standard. The extracted samples were analyzed using a UPLC-MS/MS system with positive electrospray ionization. Mobile phase A was water containing 5 mM ammonium acetate and 0.1% formic acid, and phase B was 1:1 methanol-acetonitrile with 0.1% formic acid. The method was validated and utilized to determine LEV concentrations in non-pregnant and pregnant patients with epilepsy. The developed method was validated in both plasma and saliva samples over a concentration range of 0.1-50 μg/mL. The intra- and inter-batch accuracy for LEV ranged from -7.0% to 2.9%, with precisions between 2.7% and 9.3%. In pregnant patients, the mean dose-standardized LEV trough plasma concentrations were significantly lower than those in non-pregnant patients (4.73 ± 2.99 vs. 7.74 ± 3.59 ng/mL per mg/day; P < 0.0001). It is recommended that the TDM of LEV should be routinely performed during the different stages of pregnancy.
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Affiliation(s)
- Mengyu Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Ying Jin
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wanling Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Chaoqun He
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Xiangjie Di
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yifei Duan
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Lei Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Zhenlei Wang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
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Le Merdy M, Szeto KX, Perrier J, Bolger MB, Lukacova V. PBPK Modeling Approach to Predict the Behavior of Drugs Cleared by Metabolism in Pregnant Subjects and Fetuses. Pharmaceutics 2024; 16:96. [PMID: 38258106 PMCID: PMC10820132 DOI: 10.3390/pharmaceutics16010096] [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: 12/14/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
This study aimed to develop a physiologically based pharmacokinetic (PBPK) model that simulates metabolically cleared compounds' pharmacokinetics (PK) in pregnant subjects and fetuses. This model accounts for the differences in tissue sizes, blood flow rates, enzyme expression levels, plasma protein binding, and other physiological factors affecting the drugs' PK in both the pregnant woman and the fetus. The PBPKPlus™ module in GastroPlus® was used to model the PK of metoprolol, midazolam, and metronidazole for both non-pregnant and pregnant groups. For each of the three compounds, the model was first developed and validated against PK data in healthy non-pregnant volunteers and then applied to predict the PK in the pregnant groups. The model accurately described the PK in both the non-pregnant and pregnant groups and explained well the differences in the plasma concentration due to pregnancy. When available, the fetal plasma concentration, placenta, and fetal tissue concentrations were also predicted reasonably well at different stages of pregnancy. The work described the use of a PBPK approach for drug development and demonstrates the ability to predict differences in PK in pregnant subjects and fetal exposure for metabolically cleared compounds.
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Affiliation(s)
- Maxime Le Merdy
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA 93534, USA
| | - Ke Xu Szeto
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA 93534, USA
| | - Jeremy Perrier
- PhinC Development, 36 Rue Victor Basch, 91300 Massy, France
| | - Michael B Bolger
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA 93534, USA
| | - Viera Lukacova
- Simulations Plus, Inc., 42505 10th Street West, Lancaster, CA 93534, USA
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Su M, Liu X, Zhao Y, Zhu Y, Wu M, Liu K, Yang G, Liu W, Wang L. In Silico and In Vivo Pharmacokinetic Evaluation of 84-B10, a Novel Drug Candidate against Acute Kidney Injury and Chronic Kidney Disease. Molecules 2023; 29:159. [PMID: 38202741 PMCID: PMC10780175 DOI: 10.3390/molecules29010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
Acute kidney injury (AKI) and chronic kidney disease (CKD) have become public health problems due to high morbidity and mortality. Currently, drugs recommended for patients with AKI or CKD are extremely limited, and candidates based on a new mechanism need to be explored. 84-B10 is a novel 3-phenylglutaric acid derivative that can activate the mitochondrial protease, Lon protease 1 (LONP1), and may protect against cisplatin-induced AKI and unilateral ureteral obstruction- or 5/6 nephrectomy [5/6Nx]-induced CKD model. Preclinical studies have shown that 84-B10 has a good therapeutic effect, low toxicity, and is a good prospect for further development. In the present study, the UHPLC-MS/MS method was first validated then applied to the pharmacokinetic study and tissue distribution of 84-B10 in rats. Physicochemical properties of 84-B10 were then acquired in silico. Based on these physicochemical and integral physiological parameters, a physiological based pharmacokinetic (PBPK) model was developed using the PK-Sim platform. The fitting accuracy was estimated with the obtained experimental data. Subsequently, the validated model was employed to predict the pharmacokinetic profiles in healthy and chronic kidney injury patients to evaluate potential clinical outcomes. Cmax in CKD patients was about 3250 ng/mL after a single dose of 84-B10 (0.41 mg/kg), and Cmax,ss was 1360 ng/mL after multiple doses. This study may serve in clinical dosage setting in the future.
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Affiliation(s)
- Man Su
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Xianru Liu
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Yuru Zhao
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Yatong Zhu
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Mengqiu Wu
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China;
| | - Kun Liu
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Gangqiang Yang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Wanhui Liu
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
| | - Lin Wang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (M.S.); (X.L.); (Y.Z.); (Y.Z.); (K.L.); (G.Y.)
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