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Ismail M, Straubinger T, Uchida H, Graff-Guerrero A, Nakajima S, Suzuki T, Caravaggio F, Gerretsen P, Mamo D, Mulsant BH, Pollock BG, Bies R. "MAP Bayesian modeling combining striatal dopamine receptor occupancy and plasma concentrations to optimize antipsychotic dose regimens in individual patients". Br J Clin Pharmacol 2022; 88:3341-3350. [PMID: 35112390 DOI: 10.1111/bcp.15260] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/20/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
AIM Develop a robust and user-friendly software tool for the prediction of dopamine D2 receptor occupancy (RO) in patients with schizophrenia treated with either olanzapine or risperidone, in order to facilitate clinician exploration of the impact of treatment strategies on RO using sparse plasma concentration measurements. METHODS Previously developed population pharmacokinetic (PPK) models for olanzapine and risperidone were combined with a pharmacodynamic (PD) model for D2 RO and implemented in the R programming language. Maximum a posteriori (MAP) Bayesian estimation was used to provide predictions of plasma concentration and RO based on sparse concentration sampling. These predictions were then compared to observed plasma concentration and RO. RESULTS The average (standard deviation) response times of the tools, defined as the time required for the application to predict parameter values and display the output, were 2.8 (3.1) and 5.3 (4.3) seconds for olanzapine and risperidone, respectively. The mean error (95% confidence interval) and root mean squared error (RMSE, 95% CI) of predicted versus observed concentrations were 3.73 ng/mL (-2.42 - 9.87) and 10.816 ng/mL (6.71 - 14.93) for olanzapine, and 0.46 ng/mL (-4.56 - 5.47) and 6.68 ng/mL (3.57 - 9.78) for risperidone and its active metabolite (9-OH risperidone). Mean error and RMSE of RO were -1.47% (-4.65 - 1.69) and 5.80% (3.89 - 7.72) for olanzapine and -0.91% (-7.68 - 5.85) and 8.87% (4.56 - 13.17) for risperidone. CONCLUSION Our monitoring software predicts concentration-time profiles and the corresponding D2 RO from sparsely-sampled concentration measurements in an accessible and accurate form.
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Affiliation(s)
- Mohamed Ismail
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Thomas Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ariel Graff-Guerrero
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry. University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Fernando Caravaggio
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - David Mamo
- Departments of Psychiatry & Gerontology, University of Malta, Msida, Malta
| | - Benoit H Mulsant
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Bruce G Pollock
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert Bies
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Institute for Computational and Data Sciences, University at Buffalo, Buffalo, NY, USA
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Nomura N, Kitagawa K, So R, Misawa F, Kodama M, Takeuchi H, Bies R, Straubinger T, Banker C, Mizuno Y, Mimura M, Uchida H. Comprehensive assessment of exposure to clozapine in association with side effects among patients with treatment-resistant schizophrenia: a population pharmacokinetic study. Ther Adv Psychopharmacol 2021; 11:20451253211016189. [PMID: 34046160 PMCID: PMC8138292 DOI: 10.1177/20451253211016189] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/20/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There have been scarce data on the distribution of clozapine concentrations in comparison with the recommended range (350-600 ng/ml) or their relationship with side effects among patients with treatment-resistant schizophrenia. Furthermore, no studies have assessed the association between side effects and overall exposure to the drug by calculating the 24-h area-under-curve (AUC). METHODS In- and outpatients with schizophrenia or schizoaffective disorder (ICD-10) who were receiving a stable dose of clozapine for ⩾2 weeks were included. Side effects were assessed using the Glasgow antipsychotic side-effects scale for clozapine (GASS-C). Using two collected plasma samples, plasma clozapine and norclozapine concentrations at peak and trough and their 24-h AUC were estimated using population pharmacokinetic models. RESULTS A total of 108 patients completed the study (mean ± SD age, 43.0 ± 10.1 years; clozapine dose, 357.5 ± 136.9 mg/day); 33 patients (30.6%) showed estimated trough concentrations of clozapine within the recommended range (350-600 ng/ml) whereas the concentrations were higher and lower than this range among 37 (43.5%) and 28 (25.9%) patients (%), respectively. There were no significant correlations between estimated peak or trough concentrations or 24-h AUC of both clozapine or norclozapine, and GASS-C total or individual scores. No significant differences were found between GASS-C total or individual item scores between the patients with estimated trough concentrations of clozapine of >600 ng/ml and the other subjects. CONCLUSION The results suggest that clozapine or norclozapine concentrations are not linked directly to the extent of side effects experienced in clozapine-treated patients with treatment-resistant schizophrenia while the cross-sectional study design limits the interpretation of any causal relationships. These findings indicate that side effects associated with clozapine may occur at any dose or concentration.
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Affiliation(s)
- Nobuyuki Nomura
- Department of Neuropsychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan
| | - Kohei Kitagawa
- Department of Neuropsychiatry, Okayama Psychiatric Medical Center, 3-16, Shikatahonmachi, Kita-ku, Okayama-shi, Okayama, 700-0915, Japan
| | - Ryuhei So
- Department of Neuropsychiatry, Okayama Psychiatric Medical Center, 3-16, Shikatahonmachi, Kita-ku, Okayama-shi, Okayama, 700-0915, Japan
| | - Fuminari Misawa
- Department of Neuropsychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan
| | - Masafumi Kodama
- Department of Neuropsychiatry, Okayama Psychiatric Medical Center, Okayama, Japan
| | - Hiroyoshi Takeuchi
- Department of Neuropsychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan
| | - Robert Bies
- Department of Pharmaceutical Sciences, University at Buffalo, New York, USA
| | - Thomas Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, New York, USA
| | - Christopher Banker
- Department of Pharmaceutical Sciences, University at Buffalo, New York, USA
| | - Yuya Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Donnelly M, Tsakalozou E, Sharan S, Straubinger T, Bies R, Zhao L. Review of Complex Generic Drugs Delivered Through the Female Reproductive Tract: The Current Competitive Landscape and Emerging Role of Physiologically Based Pharmacokinetic Modeling to Support Development and Regulatory Decisions. J Clin Pharmacol 2020; 60 Suppl 2:S26-S33. [PMID: 33274513 DOI: 10.1002/jcph.1760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/21/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Mark Donnelly
- Division of Quantitative Methods and Modeling (DQMM), Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), US Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Eleftheria Tsakalozou
- Division of Quantitative Methods and Modeling (DQMM), Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), US Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Satish Sharan
- Division of Quantitative Methods and Modeling (DQMM), Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), US Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Thomas Straubinger
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Robert Bies
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Liang Zhao
- Division of Quantitative Methods and Modeling (DQMM), Office of Research and Standards (ORS), Office of Generic Drugs (OGD), Center for Drug Evaluation and Research (CDER), US Food and Drug Administration (FDA), Silver Spring, Maryland, USA
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Abstract
Pre-exposure prophylaxis (PrEP) has emerged as a promising strategy for preventing the transmission of HIV. Although only one formulation is currently approved for PrEP, research into both new compounds and new delivery systems for PrEP regimens offer intriguing challenges from the perspective of pharmacokinetic and pharmacodynamic modeling. This review aims to provide an overview the current modeling landscape for HIV PrEP, focused on PK/PD and QSP models relating to antiretroviral agents. Both current PrEP treatments and new compounds that show promise as PrEP agents are highlighted, as well as models of uncommon administration routes, predictions based on models of mechanism of action and viral dynamics, and issues related to adherence to therapy. The spread of human immunodeficiency virus (HIV) remains one of the foremost global health concerns. In the absence of a vaccine, other prophylactic strategies have been developed to prevent HIV transmission. One approach, known as pre-exposure prophylaxis (PrEP), allows HIV-negative individuals who are at high risk of exposure to the virus, be it through an HIV-positive sexual partner or through the shared use of drug injection equipment, to substantially reduce the risk of developing an HIV infection. PrEP is a relatively recent approach to combating the HIV epidemic, with the only currently approved treatment being Truvada, a daily oral antiretroviral (ARV) therapy initially indicated in the treatment of active HIV-1 infections, but approved for HIV PrEP in 2012. Although PrEP therapy has consistently demonstrated high efficacy in preventing HIV infection, this efficacy is dependent on patient adherence to the prescribed treatment regimen. This can present a significant problem in low- and middle-income countries, which may lack the infrastructure to provide sufficient access to PrEP medication to maintain daily dosing regimens. Furthermore, while the conventional approach has generally been to advocate for continuous administration akin to regimens used for viral suppression in infected patients, there has been some discussion of whether a better treatment paradigm might be to push for PrEP therapy primarily during those known periods of heightened exposure risk, while relying on post-exposure prophylaxis regimens to prevent infection after unanticipated exposures during low-risk periods. These considerations have led to a push for the development of long-duration and on-demand PrEP formulations, including subdermal and subcutaneous implants, slow-release intramuscular depot injections, vaginal and rectal antimicrobial gels, and intravaginal rings and dissolving films. PrEP therapy is a quickly evolving field, with a variety of antiretroviral compounds and formulations under investigation. This review aims to report on notable drugs and formulations from a pharmacokinetic/pharmacodynamic (PK/PD) modeling perspective. Given the nature of PrEP as a preventive therapy designed for long-term use, clinical trials for PrEP therapies can last for months or even years, particularly in the case of long-duration formulations. Furthermore, in contrast to antiretroviral trials in infected patients, pharmacodynamic endpoints in PrEP therapies are difficult to quantify, as the primary endpoint for efficacy is generally the rate of seroconversion. Computational modeling approaches offer flexible and powerful tools to provide insight into drug behavior in clinical settings, and can ultimately reduce the time, expense, and patient burden incurred in the development of PrEP therapies.
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Affiliation(s)
- Thomas Straubinger
- Department of Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
| | - Katherine Kay
- Metrum Research Group, Tariffville, CT, United States
| | - Robert Bies
- Department of Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, United States
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Hartmann C, Matiwe L, Wollweber J, Gamov I, Irmscher K, Bickermann M, Straubinger T. Favourable growth conditions for the preparation of bulk AlN single crystals by PVT. CrystEngComm 2020. [DOI: 10.1039/c9ce01952a] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A high seed temperature (2251 °C) reveals the highest deep UV transparency (α265nm = 27 cm−1), a high structural perfection (EPD = 9 × 103 cm−2) and a suitable growth rate (R = 200 μm h−1).
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Affiliation(s)
- C. Hartmann
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - L. Matiwe
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - J. Wollweber
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - I. Gamov
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - K. Irmscher
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - M. Bickermann
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
| | - T. Straubinger
- Leibniz-Institut für Kristallzüchtung (IKZ)
- 12489 Berlin
- Germany
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Abstract
The present study assessed patterns of multiple drug use among a sample of university employees and students who had been identified as having moderately high drug use habits. Use of eleven categories of legal and illegal drugs was tested and subjects reported how much of each drug they currently and habitually used. Factor analysis yielded three factors of drug use. Four of the items in the first factor (hallucinogens, cocaine, marijuana, alcohol) exhibited moderately strong and positive intercorrelations, suggesting that this particular pattern of drug use was the most common and/or reliable among young adult drug users. Sedatives and opiates were the highest loading items on the second factor, suggesting a pattern of drug use motivated by the desire for relaxation and stress avoidance. The third factor identified a pattern of legal stimulant use involving two of the three food-like categories of items employed in the present study (i.e., caffeinated cola beverages and chocolate, but not coffee). The results provided only mixed support for the hypothesis that categories of drugs with similar pharmacological properties define patterns of multiple drug use.
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