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Understanding and applying pharmacometric modelling and simulation in clinical practice and research.

Standing, JF (2017) Understanding and applying pharmacometric modelling and simulation in clinical practice and research. Br J Clin Pharmacol, 83 (2). pp. 247-254. ISSN 1365-2125 https://doi.org/10.1111/bcp.13119
SGUL Authors: Standing, Joseph Frank

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Abstract

Understanding the dose-concentration-effect relationship is a fundamental component of clinical pharmacology. Interpreting data arising from observations of this relationship requires the use of mathematical models; i.e. pharmacokinetic (PK) models to describe the relationship between dose and concentration and pharmacodynamic (PD) models describing the relationship between concentration and effect. Drug development requires several iterations of pharmacometric model-informed learning and confirming. This includes modelling to understand the dose-response in preclinical studies, deriving a safe dose for first-in-man, and the overall analysis of Phase I/II data to optimise the dose for safety and efficacy in Phase III pivotal trials. However, drug development is not the boundary at which PKPD understanding and application stops. PKPD concepts will be useful to anyone involved in the prescribing and administration of medicines for purposes such as determining off-label dosing in special populations, individualising dosing based on a measured biomarker (personalised medicine) and in determining whether lack of efficacy or unexpected toxicity maybe solved by adjusting the dose rather than the drug. In clinical investigator-led study design, PKPD can be used to ensure the optimal dose is used, and crucially to define the expected effect size, thereby ensuring power calculations are based on sound prior information. In the clinical setting the most likely people to hold sufficient expertise to advise on PKPD matters will be the pharmacists and clinical pharmacologists. This paper reviews fundamental PKPD principles and provides some real-world examples of PKPD use in clinical practice and applied clinical research.

Item Type: Article
Additional Information: © 2016 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: pharmacodynamics, pharmacokinetic-pharmacodynamic modelling, pharmacokinetics, Pharmacology & Pharmacy, 1115 Pharmacology And Pharmaceutical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Br J Clin Pharmacol
ISSN: 1365-2125
Language: eng
Dates:
DateEvent
1 February 2017Published
27 August 2016Published Online
16 August 2016Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
G1002305Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 27567102
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108725
Publisher's version: https://doi.org/10.1111/bcp.13119

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