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Contenido archivado el 2024-04-30

Identification of constraints and solutions for the application of Pharmacokinetic/Pharmacodynamic modelling to clinical drug development

Objetivo

- To apply drug- and concentration-effect modelling to all phases of a clinical drug development program with the specific objective of integrating information obtained from preclinical and clinical studies so that rational choices of dosage regimens can be made at each stage of the program, ultimately leading to optimal dosing guidelines for clinical use.
- To design mathematical and statistical models linking drug-exposure (defined by both the nominal prescribed drug regimen and the actual drug regimen, as modified by non-compliance and blood concentrations) and the expected clinical effect (postulated to be of the success/failure type).
- To establish rules for the choice of "provisional" surrogate markers applicable to the early steps of the clinical development of a new drug.
- To ascertain the impact of noncompliance on the development of dosing guidelines, and in particular its impact on dose- and concentration-effect modelling and to propose tools to integrate compliance data into dose-effect models and PK/PD modelling.

A thorough investigation of PK/PD modelling will be undertaken in a phase Il/III drug development program. The major purpose of this analysis will be to define dose-concentration and concentration-response relationships. Having defined the PK/PD model, research will focus on: (a) exploration of design issues, including optimal design (from a sampling point of view) and the comparison of alternate designs such as dose-escalation; (b) the early identification of covariates; (c) the impact of logistical constraints on the design questions. Simulation studies will be used to develop guidelines for the design of prospective clinical trials. PK/PD models capable of linking categorical outcomes to PK measures will be developed and applied to data arising from phase II/1II clinical trials. The rules for defining valid "intermediate" surrogate markers for phase I and/or II clinical trials and PK/PD modelling will be defined on the basis of an analysis of data on drugs from various therapeutic areas. The models and the rules will be tested on a pooled data-base taken from a dozen clinical trials. Based on compliance patterns from existing clinical trials (without PK/PD measures), and a range of possible mechanisms for their effect on PK/PD and clinical outcome, a simulation study will generate expected systematic patterns and variation in joint observations of compliance, PK/PD and outcome. In a prospective study, using a parametric family of models for the plasma concentration curves as a function of time since dosing, the combined information on scheduled concentration measures and actual dose-time history will be used to reconstruct the curves. In a following phase and subsequent PK visits, we will consider long term and short term dosing effects by including relevant summaries of both histories in our models.

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Coordinador

University of Manchester
Aportación de la UE
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Dirección
Oxford Road
M13 9PL Manchester
Reino Unido

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