pharmacology model uses slide 1 university of auckland...
TRANSCRIPT
Slide 1
Pharmacometrics
Quantitative description of pharmacology
Nick Holford
Dept Pharmacology & Clinical Pharmacology
University of Auckland, New Zealand
Slide 2
©NHG Holford, 2017, all rights reserved.
Pharmacometrics
Pharmacology
Dose Concentration Effect
Pharmacokinetics Pharmacodynamics
Science
Models
Experiment
Slide 3
©NHG Holford, 2017, all rights reserved.
Model Uses
Description
» Correlation
» Parameters
Prediction
» Interpolation
» Extrapolation
Explanation
» True science
Slide 4
©NHG Holford, 2017, all rights reserved.
Models for WT vs HTy = 0.4711x + 134.86
R² = 0.3801
y = 2.3553x + 63.082R² = 0.8711
0
50
100
150
200
250
0 40 80 120
HT
cmWT kgy = 35.166x0.3849
R² = 0.9187
0
50
100
150
200
250
0 40 80 120
HT
cm
WT kg
Ht=208*Wt/(Wt+16.2)
Slide 5
©NHG Holford, 2017, all rights reserved.
Model for Age vs WT
0
20
40
60
80
100
120
140
0 20 40 60 80 100
We
igh
t kg
Post natal age years
0
1
2
3
4
5
20 30 40 50
We
igh
t kg
Post Menstrual Age Weeks
Observed
Male
)/)2ln(exp(
)(/)2ln(
4max4
3
3max
2
2max
1
1max
,,
44,4
,3
,2
,1
)4321(
1)(4
)/50(13
)/50(12
)/50(11
PMATHALF
iiiii
TLAGPMATHALF
WTMAXWTi
WT
i
WT
i
WT
WTMAXi
AGEPPViAGE
WTWTiWTMAX
iWTMAX
iWTMAX
iWTMAX
eWTWTWTWTWT
eeWTFFEMTLAGPMAWT
PMATM
eWTWT
PMATM
eWTWT
PMATM
eWTFFEMWT
WT3WT3WT3
WT2WT2WT2
WT1WT1WT1
Hill2- else Hill1- then TM50PMA if
Hill2- else Hill1- then TM50PMA if
Hill2- else Hill1- then TM50PMA if
Sumpter AL, Holford NHG. Predicting weight using postmenstrual age – neonates to adults. Pediatric Anesthesia. 2011;21(3):309-15.
Slide 6
©NHG Holford, 2017, all rights reserved.
George Box
“All models are wrong
but some models are useful”
Slide 7
©NHG Holford, 2017, all rights reserved.
Modelling
Simulation
» Visualising model predictions
» Exploring model properties
Parameter Estimation
» Non-linear regression (often)
» Structural + Error models
Slide 8
©NHG Holford, 2017, all rights reserved.
Model Parts
Y = slope * X + intercept
Slide 9
©NHG Holford, 2017, all rights reserved.
Model Parts
tV
CL
eV
doseC
Slide 10
©NHG Holford, 2017, all rights reserved.
Pharmacokinetics
Drug Elimination
Bolus Input
Infusion Input
tV
CL
eV
doseC
)1(t
V
CL
eCL
rateC
ConcCLRateOut *
Slide 11
©NHG Holford, 2017, all rights reserved.
Receptors/Enzymes
Ligand Binding
Enzyme Velocity
CbB Cu
Cu KdNS Cu
max
VV S
S Km
max
Slide 12
©NHG Holford, 2017, all rights reserved.
Pharmacodynamics
Emax
Sigmoid Emax
050
maxS
CC
CEE
050
maxS
CC
CEE
HillHill
Hill
Slide 13
©NHG Holford, 2017, all rights reserved.
PK Model Building
One compartment model
» First order elimination
» Mixed order elimination
» Combined First order and Mixed order
Two compartment model
» First order elimination
» etc
Slide 14
©NHG Holford, 2017, all rights reserved.
PD Model Building
Single Drug
» Linear
» Emax
» Sigmoid Emax
Combinations
» Competitive
» Non-competitive
Slide 15
©NHG Holford, 2017, all rights reserved.
PKPD Model Building
PK Model
» One compartment, etc
Link Model
» Immediate
» Slow receptor dissociation
» Distribution delay
» Turnover of mediator
PD Model
» Linear, etc
Slide 16
©NHG Holford, 2017, all rights reserved.
Pharmacometric Tools
Simulation
» Excel
» Berkeley Madonna
» Certara Trial Simulator
Individual Non-Linear Regression
» WinNonLin
Population Non-Linear Regression
» NONMEM / Monolix
Slide 17
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Slide 18
©NHG Holford, 2017, all rights reserved.
Berkeley Madonna
Slide 19
©NHG Holford, 2017, all rights reserved.
CertaraTrial Simulator
Slide 20
©NHG Holford, 2017, all rights reserved.
Certara Trial Simulator
Slide 21
©NHG Holford, 2017, all rights reserved.
Slide 22
©NHG Holford, 2017, all rights reserved.
Monolix Model
INPUT:
parameter={htmax,wt50}
regressor={wt}
EQUATION:
ht=htmax*wt/(wt+wt50)
OUTPUT:
output = {ht}
Slide 23
©NHG Holford, 2017, all rights reserved.
VPC Emax WT vs HT
Slide 24
©NHG Holford, 2017, all rights reserved.
Phoenix allows models to be run using WinNonLin, nlme (Phoenix population model) and NONMEM
Slide 25
©NHG Holford, 2017, all rights reserved.
Slide 26
©NHG Holford, 2017, all rights reserved.
NONMEM$PROB Demographics from GFR data
$INPUT ID WT HT=DV PMA SEX
$DATA demographics.csv
$EST METHOD=COND LAPLACIAN
NSIG=3 SIGL=9 MAX=9990
$COV
$THETA
200. ; POP_WMAX kg
10 ; POP_WT50 cm
$OMEGA 0 FIX ; PPV_WMAX
$SIGMA 20 ; RUV_SD cm
$PRED
WMAX=POP_WMAX*EXP(PPV_WMAX)
WT50=POP_WT50
Y=WMAX*WT/(WT+WT50) + RUV_SD
$TABLE ID WT DV PMA SEX
ONEHEADER NOPRINT FILE=emax_ruvsd.fit
Slide 27
©NHG Holford, 2017, all rights reserved.
NONMEMTHETA: POP_WMAX POP_WT50
ETA: PPV_WMAX
ERR: RUV_SD
wmax_ruvsd.lst 1935.526 FOCE eval=86 sig=3.8 sub=391 obs=391 NM7.3.0
THETA = 209 16.3
ETASD = 0.000
ETAPval = 1.000
ETAshr% = 100.0
EBVshr% = 0.0
EPSshr% = 0.0
EPSSD = 7.211
MINIMIZATION SUCCESSFUL