Theoretical Performance of Nonlinear Mixed-Effect Models Incorporating Saliva as an Alternative Sampling Matrix for Therapeutic Drug Monitoring in Pediatrics: A Simulation Study
Conclusions:
Saliva as an alternative matrix for noninvasive TDM is possible using nonlinear mixed-effect models combined with Bayesian optimization. This article provides a workflow to explore TDM performance for compounds measured in saliva and can be used for evaluation during model building. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Using Population Pharmacokinetic Modeling to Estimate Exposure to Δ9-Tetrahydrocannabinol in an Observational Study of Cannabis Smokers in Colorado
Background:
Self-report questionnaires, weighing products consumed, and Δ9-tetrahydrocannabinol (THC) biomarkers are established techniques for estimating cannabis exposure. Population pharmacokinetic modeling of plasma THC and metabolite concentrations by incorporating self-reported and weighed products as covariates could improve estimates of THC exposure in regular cannabis users.
Methods:
In this naturalistic study, blood samples were obtained from 36 regular smokers of cannabis for analysis of THC and its 2 metabolites at 4 time points: recruitment and during an experimental mobile laboratory assessment th...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Performance Evaluation of Warfarin Dose Prediction Algorithms and Effects of Clinical Factors on Warfarin Dose in Chinese Patients
Conclusions:
In Chinese patients, OHNO should be given priority during the prediction and selection of warfarin dose. When using OHNO to predict warfarin dose (≤3 mg/d or>5 mg/d), HUANG or KIM algorithms can provide precise predictions. At the same time, physicians should pay close attention to clinical factors, such as VKORC1 (rs9923231), concurrent atrial fibrillation status, CYP2C9*3 (rs1057910), body mass index, and sex, to improve warfarin dose adjustment strategies in Chinese patients. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Population Pharmacokinetics of Teicoplanin and Its Dosing Recommendations for Neutropenic Patients With Augmented Renal Clearance for Hematological Malignancies
Conclusions:
The PPK model may help optimize dose regimens and evaluate dosing methods, using comparative simulations, in patients with hematological malignancies. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
A Population Pharmacokinetic Modeling and Simulation Study of Posaconazole Oral Suspension in Immunocompromised Pediatric Patients: A Short Communication
Background:
Posaconazole oral suspension emerged as a promising candidate for prophylaxis of invasive fungal infections in immunocompromised children. Its pharmacodynamic advantages include a broad-spectrum activity and a favorable safety profile; however, they are overshadowed by its large pharmacokinetic (PK) variability, which might cause subtherapeutic exposure. The aim of this study was to develop a population (pop) PK model based on rich sampling data to better understand the PK of posaconazole oral suspension in pediatric patients.
Methods:
Data were obtained from a prospective interventional study involv...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Bayesian Forecasting for Intravenous Tobramycin Dosing in Adults With Cystic Fibrosis Using One Versus Two Serum Concentrations in a Dosing Interval
The objective of this study was to determine the potential for a sparse-sampling strategy using a single postinfusion tobramycin concentration and Bayesian forecasting to assess the AUC24 in routine practice.
Methods:
Adults with cystic fibrosis receiving once-daily tobramycin had paired concentrations measured 2 hours (c1) and 6 hours (c2) after the end of infusion as routine monitoring. AUC24 exposures were estimated using Tucuxi, a Bayesian forecasting application that incorporates a validated population pharmacokinetic model. Simulations were performed to estimate AUC24 using the full data set using c1 and c2, c...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
A Population Pharmacokinetic Modeling Approach to Determine the Efficacy of Intravenous Amikacin in Children with Cystic Fibrosis
Conclusions:
For intermediate pathogens, a dose of at least 40 mg/kg/d can improve efficacy, with an acceptable calculated residual trough level in cases of normal or hyperfiltration. Because amikacin undergoes renal clearance, which is immature until 1 year of age, dosing recommendations for this age group may be markedly high, warranting cautious interpretation. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Can We Predict Individual Concentrations of Tacrolimus After Liver Transplantation? Application and Tweaking of a Published Population Pharmacokinetic Model in Clinical Practice
Conclusions:
A pharmacokinetic model can be used, and to improve the predictive performance, tweaking the literature model with the $PRIOR approach allows to obtain better predictions. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Impact of a Bayesian Individualization of Cyclosporine Dosage Regimen for Children Undergoing Allogeneic Hematopoietic Cell Transplantation: A Cost-Effectiveness Analysis
Background:
Cyclosporine A (CsA) is the main drug used to prevent graft-versus-host disease in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). CsA therapeutic drug monitoring (TDM) has been performed for ages, with studies revealing clinical benefits, but failing to examine its economic impact. In this article, the main objective was to evaluate the economic impact of the CsA TDM strategy, based on a Bayesian approach, by assessing costs related to its clinical impact. Furthermore, TDM effectiveness was analyzed for pharmacokinetics and clinical outcomes.
Methods:
A cost-effective,...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Tacrolimus Bayesian Dose Adjustment in Pediatric Renal Transplant Recipients
Background:
Immunosuppressant Bayesian Dose Adjustment (ISBA) is an online expert system that estimates the area under the curve (AUC) of immunosuppressive drugs through pharmacokinetic modelling and Bayesian estimation to propose dose adjustments to reach predefined exposure targets. The ISBA database was retrospectively analyzed to describe tacrolimus pharmacokinetics and exposure, evaluate the efficiency of ISBA dose recommendations, and propose tacrolimus AUC0–12h target ranges for pediatric renal allograft recipients treated with immediate release tacrolimus.
Methods:
The database included 1935 tacrolimus...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
To Estimate or to Forecast? Lessons From a Comparative Analysis of Four Bayesian Fitting Methods Based on Nonparametric Models
The objective of this study was to compare the performance of the maximum a posteriori (MAP) model, multiple model (MM), interacting MM (IMM), and novel hybrid MM(HMM) in estimating past concentrations and predicting future concentrations during therapy. Amikacin and vancomycin PK data were analyzed in older hospitalized patients using 2 strategies. First, the entire data set of each patient was fitted using each of the 4 methods implemented in BestDose software. Then, the 4 methods were used in each therapeutic drug monitoring occasion to estimate the past concentrations available at this time and to predict the subsequen...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Editorial: In Memory of Roger Jelliffe, MD
No abstract available (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Dr. Roger Jelliffe Memorial Issue: Focus on Personalized Dosing Strategies Source Type: research
Severe Inflammation, Acute Kidney Injury, and Drug–Drug Interaction: Triple Penalty for Prolonged Elimination of Apixaban in Patients With Coronavirus Disease 2019: A Grand Round
Abstract:
In this article, we present a case of apixaban elimination prolonged by 450% in a patient with coronavirus disease 2019 because of multiple conditions, including drug–drug interaction, severe inflammation, and acute kidney injury. Therapeutic drug monitoring was used to explain unusual routine coagulation assays. This grand round highlights the importance of dialog between the clinician and a therapeutic drug monitoring consultant for optimal patient care. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Grand Rounds Source Type: research
Pharmacokinetic/Pharmacodynamic Dosage Individualization of Cefepime in Critically Ill Patients: A Case Study
Conclusion:
This case report illustrates how physiological, microbiological, and drug concentration data can be used for model-based dosage individualization of cefepime in intensive care unit patients. (Source: Therapeutic Drug Monitoring)
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Grand Rounds Source Type: research
Therapeutic Drug Monitoring of Erlotinib in Non-Small Cell Lung Carcinoma: A Case Study
We describe a clinical case of an 84-year-old man diagnosed with non-small cell lung carcinoma and epidermal growth factor receptor mutation, who was treated with erlotinib, with doses adjusted by therapeutic drug monitoring. This case involved a clearance fluctuation leading to over-therapeutic drug concentrations of erlotinib and toxicity. The intrapatient and interpatient variability of erlotinib, in addition to other factors such as age or variations in liver clearance, create situations that are challenging in clinical practice. During treatment, erlotinib serum concentrations were measured, and the dose was according...
Source: Therapeutic Drug Monitoring - July 24, 2021 Category: Drugs & Pharmacology Tags: Grand Rounds Source Type: research
