Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs

Abstract Tuberculosis (TB) remains a global health problem and there is an ongoing effort to develop more effective therapies and new combination regimes that can reduce duration of treatment. The purpose of this study was to demonstrate utility of a physiologically‐based pharmacokinetic modeling ap...

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Autores principales:	Helen Humphries, Lisa Almond, Alexander Berg, Iain Gardner, Oliver Hatley, Xian Pan, Ben Small, Mian Zhang, Masoud Jamei, Klaus Romero
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/1f55df4e4fa5444cbd1301d827c62ac4
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spelling	oai:doaj.org-article:1f55df4e4fa5444cbd1301d827c62ac42021-11-15T18:41:53ZDevelopment of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs2163-830610.1002/psp4.12707https://doaj.org/article/1f55df4e4fa5444cbd1301d827c62ac42021-11-01T00:00:00Zhttps://doi.org/10.1002/psp4.12707https://doaj.org/toc/2163-8306Abstract Tuberculosis (TB) remains a global health problem and there is an ongoing effort to develop more effective therapies and new combination regimes that can reduce duration of treatment. The purpose of this study was to demonstrate utility of a physiologically‐based pharmacokinetic modeling approach to predict plasma and lung concentrations of 11 compounds used or under development as TB therapies (bedaquiline [and N‐desmethyl bedaquiline], clofazimine, cycloserine, ethambutol, ethionamide, isoniazid, kanamycin, linezolid, pyrazinamide, rifampicin, and rifapentine). Model accuracy was assessed by comparison of simulated plasma pharmacokinetic parameters with healthy volunteer data for compounds administered alone or in combination. Eighty‐four percent (area under the curve [AUC]) and 91% (maximum concentration [Cmax]) of simulated mean values were within 1.5‐fold of the observed data and the simulated drug‐drug interaction ratios were within 1.5‐fold (AUC) and twofold (Cmax) of the observed data for nine (AUC) and eight (Cmax) of the 10 cases. Following satisfactory recovery of plasma concentrations in healthy volunteers, model accuracy was assessed further (where patients’ with TB data were available) by comparing clinical data with simulated lung concentrations (9 compounds) and simulated lung: plasma concentration ratios (7 compounds). The 5th–95th percentiles for the simulated lung concentration data recovered between 13% (isoniazid and pyrazinamide) and 88% (pyrazinamide) of the observed data points (Am J Respir Crit Care Med, 198, 2018, 1208; Nat Med, 21, 2015, 1223; PLoS Med, 16, 2019, e1002773). The impact of uncertain model parameters, such as the fraction of drug unbound in lung tissue mass (fumass), is discussed. Additionally, the variability associated with the patient lung concentration data, which was sparse and included extensive within‐subject, interlaboratory, and experimental variability (as well interindividual variability) is reviewed. All presented models are transparently documented and are available as open‐source to aid further research.Helen HumphriesLisa AlmondAlexander BergIain GardnerOliver HatleyXian PanBen SmallMian ZhangMasoud JameiKlaus RomeroWileyarticleTherapeutics. PharmacologyRM1-950ENCPT: Pharmacometrics & Systems Pharmacology, Vol 10, Iss 11, Pp 1382-1395 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Therapeutics. Pharmacology RM1-950
spellingShingle	Therapeutics. Pharmacology RM1-950 Helen Humphries Lisa Almond Alexander Berg Iain Gardner Oliver Hatley Xian Pan Ben Small Mian Zhang Masoud Jamei Klaus Romero Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
description	Abstract Tuberculosis (TB) remains a global health problem and there is an ongoing effort to develop more effective therapies and new combination regimes that can reduce duration of treatment. The purpose of this study was to demonstrate utility of a physiologically‐based pharmacokinetic modeling approach to predict plasma and lung concentrations of 11 compounds used or under development as TB therapies (bedaquiline [and N‐desmethyl bedaquiline], clofazimine, cycloserine, ethambutol, ethionamide, isoniazid, kanamycin, linezolid, pyrazinamide, rifampicin, and rifapentine). Model accuracy was assessed by comparison of simulated plasma pharmacokinetic parameters with healthy volunteer data for compounds administered alone or in combination. Eighty‐four percent (area under the curve [AUC]) and 91% (maximum concentration [Cmax]) of simulated mean values were within 1.5‐fold of the observed data and the simulated drug‐drug interaction ratios were within 1.5‐fold (AUC) and twofold (Cmax) of the observed data for nine (AUC) and eight (Cmax) of the 10 cases. Following satisfactory recovery of plasma concentrations in healthy volunteers, model accuracy was assessed further (where patients’ with TB data were available) by comparing clinical data with simulated lung concentrations (9 compounds) and simulated lung: plasma concentration ratios (7 compounds). The 5th–95th percentiles for the simulated lung concentration data recovered between 13% (isoniazid and pyrazinamide) and 88% (pyrazinamide) of the observed data points (Am J Respir Crit Care Med, 198, 2018, 1208; Nat Med, 21, 2015, 1223; PLoS Med, 16, 2019, e1002773). The impact of uncertain model parameters, such as the fraction of drug unbound in lung tissue mass (fumass), is discussed. Additionally, the variability associated with the patient lung concentration data, which was sparse and included extensive within‐subject, interlaboratory, and experimental variability (as well interindividual variability) is reviewed. All presented models are transparently documented and are available as open‐source to aid further research.
format	article
author	Helen Humphries Lisa Almond Alexander Berg Iain Gardner Oliver Hatley Xian Pan Ben Small Mian Zhang Masoud Jamei Klaus Romero
author_facet	Helen Humphries Lisa Almond Alexander Berg Iain Gardner Oliver Hatley Xian Pan Ben Small Mian Zhang Masoud Jamei Klaus Romero
author_sort	Helen Humphries
title	Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
title_short	Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
title_full	Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
title_fullStr	Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
title_full_unstemmed	Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
title_sort	development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/1f55df4e4fa5444cbd1301d827c62ac4
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Development of physiologically‐based pharmacokinetic models for standard of care and newer tuberculosis drugs

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