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Application of the Optimal Design Approach to Improve a Pretransplant Drug Dose Finding Design for Ciclosporin
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. (Farmakometri)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. (Farmakometri)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
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2012 (English)In: Journal of clinical pharmacology, ISSN 0091-2700, E-ISSN 1552-4604, Vol. 52, no 3, 347-360 p.Article in journal (Refereed) Published
Abstract [en]

A time and sampling intensive pretransplant test dose design was to be reduced, but at the same time optimized so that there was no loss in the precision of predicting the individual pharmacokinetic (PK) estimates of posttransplant dosing. The following variables were optimized simultaneously: sampling times, ciclosporin dose, time of second dose, infusion duration, and administration order, using a published ciclosporin population PK model as prior information. The original design was reduced from 22 samples to 6 samples/patient and both doses (intravenous oral) were administered within 8 hours. Compared with the prior information given by the published ciclosporin population PK model, the expected standard deviations (SDs) of the individual parameters for clearance and bioavailability could be reduced by, on average, 40% under the optimized sparse designs. The gain of performing the original rich design compared with the optimal reduced design, considering the standard errors of the parameter estimates, was found to be minimal. This application demonstrates, in a practical clinical scenario, how optimal design techniques may be used to improve diagnostic procedures given available software and methods.

Place, publisher, year, edition, pages
2012. Vol. 52, no 3, 347-360 p.
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-160467DOI: 10.1177/0091270010397731ISI: 000300755600006PubMedID: 21543664OAI: oai:DiVA.org:uu-160467DiVA: diva2:451135
Available from: 2011-10-24 Created: 2011-10-24 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Practical Optimal Experimental Design in Drug Development and Drug Treatment using Nonlinear Mixed Effects Models
Open this publication in new window or tab >>Practical Optimal Experimental Design in Drug Development and Drug Treatment using Nonlinear Mixed Effects Models
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The cost of releasing a new drug on the market has increased rapidly in the last decade. The reasons for this increase vary with the drug, but the need to make correct decisions earlier in the drug development process and to maximize the information gained throughout the process is evident.

Optimal experimental design (OD) describes the procedure of maximizing relevant information in drug development and drug treatment processes. While various optimization criteria can be considered in OD, the most common is to optimize the unknown model parameters for an upcoming study. To date, OD has mainly been used to optimize the independent variables, e.g. sample times, but it can be used for any design variable in a study.

This thesis addresses the OD of multiple continuous or discrete design variables for nonlinear mixed effects models. The methodology for optimizing and the optimization of different types of models with either continuous or discrete data are presented and the benefits of OD for such models are shown. A software tool for optimizing these models in parallel is developed and three OD examples are demonstrated: 1) optimization of an intravenous glucose tolerance test resulting in a reduction in the number of samples by a third, 2) optimization of drug compound screening experiments resulting in the estimation of nonlinear kinetics and 3) an individual dose-finding study for the treatment of children with ciclosporin before kidney transplantation resulting in a reduction in the number of blood samples to ~27% of the original number and an 83% reduction in the study duration.

This thesis uses examples and methodology to show that studies in drug development and drug treatment can be optimized using nonlinear mixed effects OD. This provides a tool than can lower the cost and increase the overall efficiency of drug development and drug treatment.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 149
Keyword
Pharmacometrics, optimal design, nonlinear mixed effects models, robust design, optimizing drug development, population models
National Category
Pharmaceutical Sciences
Research subject
Pharmacokinetics and Drug Therapy
Identifiers
urn:nbn:se:uu:diva-160481 (URN)978-91-554-8202-2 (ISBN)
Public defence
2011-12-09, B21, Biomedicinskt Centrum, Husargatan 3, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2011-11-18 Created: 2011-10-24 Last updated: 2011-11-23Bibliographically approved

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Hennig, StefanieNyberg, JoakimHooker, Andrew CKarlsson, Mats O

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