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Rodríguez-Fernández K, Reynaldo-Fernández G, Reyes-González S, de Las Barreras C, Rodríguez-Vera L, Vlaar C, Monbaliu JCM, Stelzer T, Duconge J, Mangas-Sanjuan V. New insights into the role of VKORC1 polymorphisms for optimal warfarin dose selection in Caribbean Hispanic patients through an external validation of a population PK/PD model. Biomed Pharmacother 2024; 170:115977. [PMID: 38056237 PMCID: PMC10853672 DOI: 10.1016/j.biopha.2023.115977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023] Open
Abstract
Warfarin, an oral anticoagulant, has been used for decades to prevent thromboembolic events. The complex interplay between CYP2C9 and VKORC1 genotypes on warfarin PK and PD properties is not fully understood in special sub-groups of patients. This study aimed to externally validate a population pharmacokinetic/pharmacodynamic (PK/PD) model for the effect of warfarin on international normalized ratio (INR) and to evaluate optimal dosing strategies based on the selected covariates in Caribbean Hispanic patients. INR, and CYP2C9 and VKORC1 genotypes from 138 patients were used to develop a population PK/PD model in NONMEM. The structural definition of a previously published PD model for INR was implemented. A numerical evaluation of the parameter-covariate relationship was performed. Simulations were conducted to determine optimal dosing strategies for each genotype combinations, focusing on achieving therapeutic INR levels. Findings revealed elevated IC50 for G/G, G/A, and A/A VKORC1 haplotypes (11.76, 10.49, and 9.22 mg/L, respectively), in this population compared to previous reports. The model-guided dosing analysis recommended daily warfarin doses of 3-5 mg for most genotypes to maintain desired INR levels, although subjects with combination of CYP2C9 and VKORC1 genotypes * 2/* 2-, * 2/* 3- and * 2/* 5-A/A would require only 1 mg daily. This research underscores the potential of population PK/PD modeling to inform personalized warfarin dosing in populations typically underrepresented in clinical studies, potentially leading to improved treatment outcomes and patient safety. By integrating genetic factors and clinical data, this approach could pave the way for more effective and tailored anticoagulation therapy in diverse patient groups.
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Affiliation(s)
- Karine Rodríguez-Fernández
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain
| | | | - Stephanie Reyes-González
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, PR, USA
| | | | - Leyanis Rodríguez-Vera
- Center for Pharmacometrics and System Pharmacology at Lake Nona (Orlando), Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA
| | - Cornelis Vlaar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, PR, USA
| | - Jean-Christophe M Monbaliu
- Center for Integrated Technology and Organic Synthesis, MolSys Research Unit, University of Liège, B-4000 Liège (Sart Tilman), Liège, Belgium
| | - Torsten Stelzer
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, PR, USA; Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan 00926, PR, USA
| | - Jorge Duconge
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, PR, USA.
| | - Victor Mangas-Sanjuan
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain; Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia, Valencia, Spain
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de Castro-Suárez N, Trame MN, Ramos-Suzarte M, Dávalos JM, Bacallao-Mendez RA, Maceo-Sinabele AR, Mangas-Sanjuán V, Reynaldo-Fernández G, Rodríguez-Vera L. Semi-Mechanistic Pharmacokinetic Model to Guide the Dose Selection of Nimotuzumab in Patients with Autosomal Dominant Polycystic Kidney Disease. Pharmaceutics 2020; 12:pharmaceutics12121147. [PMID: 33256255 PMCID: PMC7760646 DOI: 10.3390/pharmaceutics12121147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease characterized by an overexpression of epidermal growth factor receptor (EGFR). Nimotuzumab is a recombinant humanized monoclonal antibody against human EGFR. The aim of this study was to develop a population pharmacokinetic model for nimotuzumab and to identify demographic and clinical predictive factors of the pharmacokinetic variability. The population pharmacokinetics (PopPK) of nimotuzumab was characterized using a nonlinear mixed-effect modeling approach with NONMEM®. A total of 422 log-transformed concentration-versus-time datapoints from 20 patients enrolled in a single-center phase I clinical trial were used. Quasi steady state approximation of the full TMDD (target-mediated drug disposition) model with constant target concentration best described the concentration-time profiles. A turnover mediator was included which stimulates the non-specific clearance of mAb in the central compartment in order to explain the reduced levels at higher doses. Covariates had no influence on the PK (pharmacokinetics) parameters. The model was able to detect that the maximum effective dose in ADPKD subjects is 100 mg. The developed PopPK model may be used to guide the dose selection for nimotuzumab during routine clinical practice in patients with polycystic kidney disease. The model will further support the ongoing investigations of the PK/PD relationships of nimotuzumab to improve its therapeutic use in other disease areas.
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Affiliation(s)
- Niurys de Castro-Suárez
- Pharmacy Department, Institute of Food and Pharmacy, University of Havana, Havana 11300, Cuba; (N.d.C.-S.); (G.R.-F.); (L.R.-V.)
| | - Mirjam N. Trame
- AVROBIO Inc., Department of Translational Data Sciences and Advanced Analytics, Cambridge, MA 02139, USA;
| | | | - José M. Dávalos
- National Institute of Nephrology (INEF), Havana 10400, Cuba; (J.M.D.); (R.A.B.-M.)
| | | | | | - Víctor Mangas-Sanjuán
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, 46100 Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia, University of Valencia, 46100 Valencia, Spain
- Correspondence: ; Tel.: +3-49-6354-3351
| | - Gledys Reynaldo-Fernández
- Pharmacy Department, Institute of Food and Pharmacy, University of Havana, Havana 11300, Cuba; (N.d.C.-S.); (G.R.-F.); (L.R.-V.)
| | - Leyanis Rodríguez-Vera
- Pharmacy Department, Institute of Food and Pharmacy, University of Havana, Havana 11300, Cuba; (N.d.C.-S.); (G.R.-F.); (L.R.-V.)
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Rodríguez-Escudero I, Cedeño JA, Rodríguez-Nazario I, Reynaldo-Fernández G, Rodríguez-Vera L, Morales N, Jiménez-Vélez B, Ruaño G, Duconge J. Assessment of the clinical utility of pharmacogenetic guidance in a comprehensive medication management service. J Am Coll Clin Pharm 2020; 3:1028-1037. [PMID: 32964197 PMCID: PMC7505210 DOI: 10.1002/jac5.1250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/12/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Pharmacists are poised to be the health care professionals best suited to provide medication-related consults and services based on a patient's genetics. Despite its potential benefits, the implementation of pharmacogenetic (PGx) testing into primary clinical settings has been slow among medically underserved populations. To our knowledge, this is the first time that PGx-driven recommendations have been incorporated into a Comprehensive Medication Management (CMM) service in a Hispanic population. OBJECTIVES The aim of this study is to evaluate the clinical utility of adding PGx guidance into pharmacist-driven CMM. METHODS This is a pre- and post-interventional design study. Patients were recruited from a psychologist's clinic. A total of 24 patients had a face-to-face interview with a pharmacist to complete a CMM, Personal Medication Record, and Medication-Related Action Plan (MAP) blind to PGx findings. Collected buccal DNA samples were genotyped using drug-metabolizing enzymes and transporters (DMET) Plus Array. RESULTS The pharmacist generated new MAPs for each patient based on PGx results. Genetic variants that could potentially affect the safety and effectiveness of at least one drug in the pharmacotherapy were identified in 96% of patients, for whom the pharmacist changed the initial recommendations. Polymorphisms in genes encoding for isoenzymes CYP2D6, CYP2C19, and CYP2C9 were identified in 83%, 52%, and 41% of patients, respectively. Pharmacists performing CMM identified 22 additional medication problems after PGx determinations. Moreover, they agreed with the clinical utility of PGx in the studied sample based on perceived value of adding PGx to traditional CMM and its utility in the decision-making process of pharmacists. CONCLUSIONS The study confirmed the critical role to be played by pharmacists in facilitating the clinical usage of relevant genetic information to optimize drug therapy decisions as well as their involvement on many levels of these multidisciplinary implementation efforts, including championing and leading PGx-guided CMM services.
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Affiliation(s)
| | - Julio A. Cedeño
- School of Pharmacy, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | | | | | - Braulio Jiménez-Vélez
- Department of Biochemistry, University of Puerto Rico, Medical Sciences Campus, School of Medicine, San Juan, Puerto Rico
| | - Gualberto Ruaño
- Institute of Living at Hartford Hospital, Laboratory of Personalized Health, Genomas, Inc., Hartford, Connecticut
| | - Jorge Duconge
- School of Pharmacy, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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4
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Reyes-González S, de las Barreras C, Reynaldo G, Rodríguez-Vera L, Vlaar C, Lopez Mejias V, Monbaliu JCM, Stelzer T, Mangas V, Duconge J. Genotype-driven pharmacokinetic simulations of warfarin levels in Puerto Ricans. Drug Metab Pers Ther 2020; 0:/j/dmdi.ahead-of-print/dmdi-2020-0135/dmdi-2020-0135.xml. [PMID: 32809952 PMCID: PMC7892629 DOI: 10.1515/dmdi-2020-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/07/2020] [Indexed: 11/15/2022]
Abstract
Objectives The inter-individual variability of warfarin dosing has been linked to genetic polymorphisms. This study was aimed at performing genotype-driven pharmacokinetic (PK) simulations to predict warfarin levels in Puerto Ricans. Methods Analysis of each individual dataset was performed by one-compartmental modeling using WinNonlin®v6.4. The k e of warfarin given a cytochrome P450 2C9 (CYP2C9) genotype ranged from 0.0189 to 0.0075 h-1. K a and V d parameters were taken from literature. Data from 128 subjects were divided into two groups (i.e., wild-types and carriers) and statistical analyses of PK parameters were performed by unpaired t-tests. Results In the carrier group (n=64), 53 subjects were single-carriers and 11 double-carriers (i.e., *2/*2, *2/*3, *2/*5, *3/*5, and *3/*8). The mean peak concentration (Cmax) was higher for wild-type (0.36±0.12 vs. 0.32±0.14 mg/L). Likewise, the average clearance (CL) parameter was faster among non-carriers (0.22±0.03 vs. 0.17±0.05 L/h; p=0.0001), with also lower area under the curve (AUC) when compared to carriers (20.43±6.97 vs. 24.78±11.26 h mg/L; p=0.025). Statistical analysis revealed a significant difference between groups with regard to AUC and CL, but not for Cmax. This can be explained by the variation of k e across different genotypes. Conclusions The results provided useful information for warfarin dosing predictions that take into consideration important individual PK and genotyping data.
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Affiliation(s)
- Stephanie Reyes-González
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
| | | | - Gledys Reynaldo
- Institute of Pharmacy and Foods, University of Havana, Havana, Cuba
| | | | - Cornelis Vlaar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
| | - Vilmali Lopez Mejias
- Department of Chemistry, University of Puerto Rico - Río Piedras Campus, San Juan 00931, Puerto Rico, USA
- Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan 00926, Puerto Rico, USA
| | - Jean-Christophe M. Monbaliu
- Center for Integrated Technology and Organic Synthesis, MolSys Research Unit, University of Liège, B-4000 Liège (Sart Tilman), Liège, Belgium
| | - Torsten Stelzer
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
- Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan 00926, Puerto Rico, USA
| | - Victor Mangas
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia. Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia. Valencia, Spain
| | - Jorge Duconge
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
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5
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Reyes-González S, de Las Barreras C, Reynaldo G, Rodríguez-Vera L, Vlaar C, Mejias VL, Monbaliu JCM, Stelzer T, Mangas V, Duconge J. Genotype-driven pharmacokinetic simulations of warfarin levels in Puerto Ricans. Drug Metab Pers Ther 2020; 35:dmpt-2020-0135. [PMID: 34704696 DOI: 10.1515/dmpt-2020-0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/07/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The inter-individual variability of warfarin dosing has been linked to genetic polymorphisms. This study was aimed at performing genotype-driven pharmacokinetic (PK) simulations to predict warfarin levels in Puerto Ricans. METHODS Analysis of each individual dataset was performed by one-compartmental modeling using WinNonlin®v6.4. The k e of warfarin given a cytochrome P450 2C9 (CYP2C9) genotype ranged from 0.0189 to 0.0075 h-1. K a and V d parameters were taken from literature. Data from 128 subjects were divided into two groups (i.e., wild-types and carriers) and statistical analyses of PK parameters were performed by unpaired t-tests. RESULTS In the carrier group (n=64), 53 subjects were single-carriers and 11 double-carriers (i.e., *2/*2, *2/*3, *2/*5, *3/*5, and *3/*8). The mean peak concentration (Cmax) was higher for wild-type (0.36±0.12 vs. 0.32±0.14 mg/L). Likewise, the average clearance (CL) parameter was faster among non-carriers (0.22±0.03 vs. 0.17±0.05 L/h; p=0.0001), with also lower area under the curve (AUC) when compared to carriers (20.43±6.97 vs. 24.78±11.26 h mg/L; p=0.025). Statistical analysis revealed a significant difference between groups with regard to AUC and CL, but not for Cmax. This can be explained by the variation of k e across different genotypes. CONCLUSIONS The results provided useful information for warfarin dosing predictions that take into consideration important individual PK and genotyping data.
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Affiliation(s)
- Stephanie Reyes-González
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
| | | | - Gledys Reynaldo
- Institute of Pharmacy and Foods, University of Havana, Havana, Cuba
| | | | - Cornelis Vlaar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
| | - Vilmali Lopez Mejias
- Department of Chemistry, University of Puerto Rico - Río Piedras Campus, San Juan, USA.,Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, USA
| | - Jean-Christophe M Monbaliu
- Center for Integrated Technology and Organic Synthesis, MolSys Research Unit, University of Liège, Liège (Sart Tilman), Liège, Belgium
| | - Torsten Stelzer
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA.,Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, USA
| | - Victor Mangas
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain.,Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia, Valencia, Spain
| | - Jorge Duconge
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico - Medical Sciences Campus, San Juan 00936, Puerto Rico, USA
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de Castro-Suárez N, Rodríguez-Vera L, Villegas C, Dávalos-Iglesias JM, Bacallao-Mendez R, Llerena-Ferrer B, Leyva-de la Torre C, Lorenzo-Luaces P, Troche-Concepción M, Ramos-Suzarte M. Pharmacokinetic Evaluation of Nimotuzumab in Patients With Autosomal Dominant Polycystic Kidney Disease. J Clin Pharmacol 2019; 59:863-871. [PMID: 30633365 DOI: 10.1002/jcph.1376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 12/19/2018] [Indexed: 01/05/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease characterized by an overexpression and mislocalization of epidermal growth factor receptor (EGFR) to the apical membranes of cystic epithelial cells. Nimotuzumab is a humanized antibody that recognizes an extracellular domain III of human EGFR. The aim of this study was to assess the pharmacokinetic behavior of nimotuzumab in patients with ADPKD given as a single dose. A phase I, single-center, and noncontrolled open clinical study was conducted. Five patients were enrolled at each of the following fixed-dose levels: 50, 100, 200, and 400 mg. Intravenous continuous infusions of nimotuzumab were administered every 14 days during a year, except the first administration, when blood samples were drawn during 28 days for pharmacokinetic assessments. Subjects were closely monitored during the trial and at completion of the administration of nimotuzumab, including the anti-idiotypic response. For the first time, nimotuzumab was used for treating a nononcological disease. The administration of nimotuzumab showed dose-dependent kinetics. Nimotuzumab does not develop anti-idiotypic response against the murine portion present in the hypervariable region of the antibody present in the serum of the patients treated. No significant differences were found in the systemic clearance between the 100- and 400-mg dose, which indicates that the optimal biological dose is in this range of dose.
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Affiliation(s)
- Niurys de Castro-Suárez
- Laboratory of Biopharmaceutics, Department of Pharmacology & Toxicology, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | - Leyanis Rodríguez-Vera
- Laboratory of Biopharmaceutics, Department of Pharmacology & Toxicology, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | - Carlos Villegas
- National Institute of Oncology and Radiobiology, Havana, Cuba
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7
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Reynaldo-Fernández G, Solozábal J, Amaro D, Fernández-Sánchez EM, Rodríguez-Vera L, Bermejo M, Mangas-Sanjuan V, Troconiz IF. Semi-mechanistic Pharmacokinetic/Pharmacodynamic model of three pegylated rHuEPO and ior®EPOCIM in New Zealand rabbits. Eur J Pharm Sci 2018; 120:123-132. [PMID: 29729414 DOI: 10.1016/j.ejps.2018.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/30/2018] [Accepted: 04/30/2018] [Indexed: 11/19/2022]
Abstract
Marketed formulations of erythropoietin (EPO) ior®EPOCIM, MIRCERA® and two newly developed pegylated-EPO analogues (PEG-EPO 32 and 40 kDa) formulations were intravenously administered to New Zealand rabbits. A semi-mechanistic Pharmacokinetic/Pharmacodynamic (PK/PD) model describing in a simultaneous and integrated form the time course of reticulocytes, red blood cells and hemoglobin was built to account for the time course of hematopoiesis stimulation after erythropoietin administration. Data analysis was performed based on the population approach with the software NONMEM version 7.3. Erythropoietin disposition of each of the administered formulations was best described with a two compartment model and linear elimination. Different formulations show different clearance and apparent volume of distribution of the central compartment but share estimates of inter-compartmental clearance and apparent peripheral volume of distribution. A semi-mechanistic model including cell proliferation, maturation, and homeostatic regulation provided a good description of the data regardless the type of erythropoietin formulation administered. The system-, and drug-related parameters showed consistency and differed across formulations, respectively. A single IV administration of PEG-EPO 32 and 40 kDa formulations in New Zealand rabbits achieves a median change of 27% and 22% on RET levels, and of 47% and 63% on RBC and HGB levels, respectively compared to MIRCERA®. The administration of new branched PEG-chains formulations improves PK and PD properties of EPO, in terms of increasing elimination half-lives and pharmacological activity on RET, RBC and HGB compared to commercially available formulations (ior®EPOCIM and MIRCERA®).
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Affiliation(s)
- G Reynaldo-Fernández
- Department of Pharmacy, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | | | - D Amaro
- Center of Molecular Immunology, Cuba
| | - E M Fernández-Sánchez
- Department of Pharmacy, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | - L Rodríguez-Vera
- Department of Pharmacy, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | - M Bermejo
- Engineering: Pharmacy and Pharmaceutical Technology Area, Miguel Hernandez University, Spain
| | - V Mangas-Sanjuan
- Pharmacy and Pharmaceutical Technology Area, University of Valencia, Spain; Institute of Molecular Recognition and Technological Development (IDM), Joint Centre of Polytechnic University of Valencia and University of Valencia, Spain.
| | - I F Troconiz
- Pharmacometrics & Systems Pharmacology, Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
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8
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Rodríguez-Vera L, Ramos-Suzarte M, Fernández-Sánchez E, Soriano JL, Guitart CP, Hernández GC, Jacobo-Cabral CO, de Castro Suárez N, Codina HC. Semimechanistic model to characterize nonlinear pharmacokinetics of nimotuzumab in patients with advanced breast cancer. J Clin Pharmacol 2015; 55:888-98. [PMID: 25760761 DOI: 10.1002/jcph.496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study aimed (1) to develop a semimechanistic pharmacokinetic (PK) model for nimotuzumab in patients with advanced breast cancer and (2) to identify demographic, biochemical, and clinical predictive factors of the PK variability. Data from a phase 1 study were analyzed using the nonlinear mixed-effects approach (NONMEM). A target-mediated disposition model that included 2 open PK compartments, the monoclonal antibody (mAb)-target binding, and target and mAb-target complex turnovers best described the linear and nonlinear PK. Covariates had no influence on the PK parameters. The final parameter estimates were 19.93 L (steady-state volume), 0.0045-0.0172 L/h (range of total clearance values), 6.96 μg/mL (steady-state binding constant), 5.50 h(-1) (target degradation rate constant), 1.43 (μg/mL) · h(-1) (complex formation rate), and 0.148 h(-1) (complex internalization rate constant). The model described the effect of the mAb-target binding, and target and mAb-target complex turnovers on nimotuzumab PK. Simulations showed that doses above 200 mg maintained the 50% target occupancy during all of the treatment. This model can be very useful for knowing the dosing schedules required for efficacy and supports further investigation of the pharmacokinetic/pharmacodynamic relationships of nimotuzumab to improve its therapeutic use.
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Affiliation(s)
- Leyanis Rodríguez-Vera
- Laboratory of Pharmacokinetic, Department of Pharmacology & Clinical Pharmacy, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | | | - Eduardo Fernández-Sánchez
- Center for Biological Evaluation and Research, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | | | - Concepción Peraire Guitart
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | | | | | - Niurys de Castro Suárez
- Laboratory of Pharmacokinetic, Department of Pharmacology & Clinical Pharmacy, Institute of Pharmacy & Foods, University of Havana, Havana, Cuba
| | - Helena Colom Codina
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, University of Barcelona, Barcelona, Spain
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Rabasa Capote A, González JE, Rodríguez-Vera L, López A, Sánchez Ramírez B, Garrido Hidalgo G. Pharmacokinetics and Biodistribution Study of 7A7 Anti-Mouse Epidermal Growth Factor Receptor Monoclonal Antibody and Its F(ab')(2) Fragment in an Immunocompetent Mouse Model. ISRN Pharmacol 2012; 2012:417515. [PMID: 23227357 PMCID: PMC3512310 DOI: 10.5402/2012/417515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 10/23/2012] [Indexed: 11/23/2022]
Abstract
Immunocompetent mice, Fc receptor γ-chain deficient mice (Fcer1g−/−), and molecular tools as F(ab′)2 bivalent fragments appear as the most suitable biological models to study the mechanisms of the action of anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs). In vivo experiments contrasting antitumor effects of whole Abs and their bivalent fragments commonly involve a previous comparative pharmacokinetics study. In this paper, pharmacokinetics and biodistribution of an anti-mouse EGFR Ab were assessed using immunocompetent mice. 125I-labeled 7A7 mAb holds an elimination half-life (t1/2β) of 23.1 h in C57BL/6 mice. Accumulation of mAb was found in liver, spleen, kidneys, and mostly in lungs. We used an ELISA method to determine the t1/2β of a 7A7 mAb using the same experimental setting. Results from this new analysis revealed a t1/2β of 23.9 h, supporting this method as a safer and easier system to evaluate pharmacokinetics parameters of mAbs targeting mouse EGFR. Using this system we also studied pharmacokinetics of 7A7 F(ab′)2 fragment. A tenfold difference between the mAb and fragment t1/2β was found. These data support the use of the 7A7 F(ab′)2 fragment in in vivo studies to explore the contribution of the EGFR signaling blockade and the Fc region to the antitumor effect of 7A7 mAb in this autologous scenario.
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Affiliation(s)
- Ailem Rabasa Capote
- Tumor Immunology Direction, Molecular Immunology Institute, Center of Molecular Immunology, 216 Street, 15th Avenue, Atabey, Siboney, Playa, P.O. Box 16040, 11600 Havana, Cuba
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Ducongé J, Rodríguez-Vera L, Valenzuela C, Alvarez D, Ramírez O, de la Luz-Hernández KR, Rabeza-Legón EY, Casacó A, Fernández-Sánchez E. Pharmacokinetic comparison of two recombinant human granulocyte colony-stimulating factor after subcutaneous administration in rabbits. Eur J Pharm Biopharm 2005; 61:142-8. [PMID: 16126380 DOI: 10.1016/j.ejpb.2005.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2004] [Revised: 06/20/2005] [Accepted: 06/20/2005] [Indexed: 10/25/2022]
Abstract
A pharmacokinetic comparison between two formulations (LeukoCIM, CIMAB SA versus Neupogen, Hoffman-La Roche, licensed by Amgen) of recombinant human granulocyte colony-stimulating factor (rhG-CSF) using non-compartmental analysis was performed in male F1 rabbits after a single subcutaneous 11.5 microg/kg dose to help decide whether to conduct further comparability tests. Unlike the absorption phase, a statistical difference was not detected between Neupogen and LeukoCIM for clearance (18.69+/-11.83 versus 28.42+/-12.11 mL/h/kg, P=0.22). In addition, using a multivariate statistical analysis by independent samples test, a significant difference was not found between the two formulations (P=0.88). Finally, the results obtained in this study confirmed the pharmacokinetic comparability between both formulations, supporting the claim for further assessments following the current protocol on biogeneric equivalence.
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Affiliation(s)
- Jorge Ducongé
- Department of Pharmacology and Toxicology, Center for Biological Evaluation and Research, Institute of Pharmacy & Foods, University of Havana.
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