학술논문

Clinical Trial Simulations and Pharmacometric Analysis in Pediatrics: Application to Inhaled Loxapine in Children and Adolescents.
Document Type
Journal Article
Source
Clinical Pharmacokinetics. Oct2017, Vol. 56 Issue 10, p1207-1217. 11p.
Subject
*INHALATION administration
*AGITATION (Psychology)
*CLINICAL trials
*SCHIZOPHRENIA
*PHARMACOKINETICS
*THERAPEUTICS
*AGE distribution
*ANTIPSYCHOTIC agents
*BIOLOGICAL models
*COMPARATIVE studies
*DOSE-effect relationship in pharmacology
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*RESEARCH funding
*EVALUATION research
Language
ISSN
0312-5963
Abstract
Background and Objectives: Loxapine for inhalation is a drug-device combination product approved in adults for the acute treatment of agitation associated with schizophrenia or bipolar I disorder. The primary objective of this study was to develop a clinical trial protocol to support a phase I pharmacokinetic study in children aged 10 years and older. In addition, this report details the results of the clinical study in relation to the predicted likelihood of achieving the target exposure associated with therapeutic effect in adults.Methods: A nonlinear mixed-effects population pharmacokinetic model was developed using adult data and was adjusted for the targeted pediatric age groups by applying allometric scaling to account for body size effects. Based on this pediatric model, age-appropriate regimens to achieve loxapine exposures similar to the ones associated with therapeutic effect in the adult studies were identified via trial simulation. D-optimal design and power analysis were conducted to identify optimal pharmacokinetic sampling times and sample size, respectively.Results: The developed clinical trial design formed the basis of a phase I study to assess the safety and pharmacokinetics of loxapine for inhalation in children aged 10 years and older (ClinicalTrials.gov ID: NCT02184767).Conclusion: The results of the study indicated that overall loxapine exposures were consistent with what had been predicted by the trial simulations. The presented approach illustrates how modeling and simulation can assist in the design of informative clinical trials to identify safe and effective doses and dose ranges in children and adolescents. [ABSTRACT FROM AUTHOR]