Population pharmacokinetics of pregabalin in healthy subjects and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pregabalin has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and a wide variety of pain disorders. • Although pharmacokinetic studies have demonstrated that pregabalin apparent clearance is correlated with estimate...

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Veröffentlicht in:British journal of clinical pharmacology 2011-07, Vol.72 (1), p.63-76
Hauptverfasser: Shoji, Satoshi, Suzuki, Misaki, Tomono, Yoshiro, Bockbrader, Howard N., Matsui, Shigeyuki
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creator Shoji, Satoshi
Suzuki, Misaki
Tomono, Yoshiro
Bockbrader, Howard N.
Matsui, Shigeyuki
description WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pregabalin has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and a wide variety of pain disorders. • Although pharmacokinetic studies have demonstrated that pregabalin apparent clearance is correlated with estimated creatinine clearance, quantitatively accurate estimation of this relationship is warranted for establishing clinical usage of this drug. WHAT THIS STUDY ADDS • A population pharmacokinetic model was developed from 14 pregabalin clinical trials using the first‐order conditional estimation method, where a one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. • Based on the developed model, pregabalin systemic exposure in patients with lower renal function (30 ≤ estimated creatinine clearance [CLcr]
doi_str_mv 10.1111/j.1365-2125.2011.03932.x
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WHAT THIS STUDY ADDS • A population pharmacokinetic model was developed from 14 pregabalin clinical trials using the first‐order conditional estimation method, where a one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. • Based on the developed model, pregabalin systemic exposure in patients with lower renal function (30 ≤ estimated creatinine clearance [CLcr] &lt;60 ml min−1) is expected to be similar to exposure in patients with normal renal function (CLcr≥60) administered twice the dose. • This study indicated that the systemic exposure of pregabalin could be adjusted with reference to the estimated proportional relationship between pregabalin apparent clearance and CLcr regardless of the disease. AIM Pregabalin, a chemical analogue of the mammalian neurotransmitter γ‐aminobutyric acid, has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and various other pain disorders, including neuropathic pain associated with post‐herpetic neuralgia and diabetic peripheral neuropathy and fibromyalgia. The aim of this study was to develop a population pharmacokinetic model and quantify the influence of covariates on the parameters. METHODS This pregabalin population pharmacokinetic analysis was conducted on data from 14 clinical trials involving healthy subjects, subjects with impaired renal function and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy (n= 616). The data analysis was performed using nonlinear mixed effects modelling methodology as implemented by NONMEM. RESULTS A one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. The model indicated that pregabalin apparent clearance (CL/F) was proportional to estimated creatinine clearance (CLcr). The pregabalin systemic exposure in patients with lower renal function who received pregabalin 150 mg twice daily was almost equal to that of patients with normal renal function administered pregabalin 300 mg twice daily. The systemic exposure stratified by lower or normal renal function was similar between patients with post‐herpetic neuralgia and diabetic peripheral neuropathy. CONCLUSION The developed model identified CLcr and ideal body weight as clinically influential covariates on CL/F and volume of distribution, respectively. This study indicates that renal function accounts for variability in the apparent clearance of pregabalin which is consistent with what is known about the elimination of this drug.</description><identifier>ISSN: 0306-5251</identifier><identifier>EISSN: 1365-2125</identifier><identifier>DOI: 10.1111/j.1365-2125.2011.03932.x</identifier><identifier>PMID: 21306415</identifier><identifier>CODEN: BCPHBM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Analgesics - administration &amp; dosage ; Analgesics - pharmacokinetics ; Anxiety ; Biological and medical sciences ; Body weight ; Clinical trials ; Clinical Trials as Topic ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Creatinine ; Data processing ; Diabetes mellitus ; Diabetes. Impaired glucose tolerance ; Diabetic Neuropathies - metabolism ; diabetic peripheral neuropathy ; Drugs ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fibromyalgia ; gamma -Aminobutyric acid ; gamma-Aminobutyric Acid - administration &amp; dosage ; gamma-Aminobutyric Acid - analogs &amp; derivatives ; gamma-Aminobutyric Acid - pharmacokinetics ; Human viral diseases ; Humans ; Infectious diseases ; Medical sciences ; Middle Aged ; Models, Theoretical ; Nervous system (semeiology, syndromes) ; Neuralgia ; Neuralgia, Postherpetic - metabolism ; Neurology ; Neuropathy ; Neurotransmitters ; Pain ; Peripheral neuropathy ; Pharmacokinetics ; Pharmacology. Drug treatments ; population pharmacokinetics ; Population studies ; post‐herpetic neuralgia ; Pregabalin ; Renal function ; Seizures ; Viral diseases ; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye ; Young Adult</subject><ispartof>British journal of clinical pharmacology, 2011-07, Vol.72 (1), p.63-76</ispartof><rights>2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.</rights><rights>Copyright © 2011 The British Pharmacological Society 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5362-422f649c5c5b72b9325be9ef031caaf14828756519381fa695f0987dd43254473</citedby><cites>FETCH-LOGICAL-c5362-422f649c5c5b72b9325be9ef031caaf14828756519381fa695f0987dd43254473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2125.2011.03932.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2125.2011.03932.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24244975$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21306415$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shoji, Satoshi</creatorcontrib><creatorcontrib>Suzuki, Misaki</creatorcontrib><creatorcontrib>Tomono, Yoshiro</creatorcontrib><creatorcontrib>Bockbrader, Howard N.</creatorcontrib><creatorcontrib>Matsui, Shigeyuki</creatorcontrib><title>Population pharmacokinetics of pregabalin in healthy subjects and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy</title><title>British journal of clinical pharmacology</title><addtitle>Br J Clin Pharmacol</addtitle><description>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pregabalin has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and a wide variety of pain disorders. • Although pharmacokinetic studies have demonstrated that pregabalin apparent clearance is correlated with estimated creatinine clearance, quantitatively accurate estimation of this relationship is warranted for establishing clinical usage of this drug. WHAT THIS STUDY ADDS • A population pharmacokinetic model was developed from 14 pregabalin clinical trials using the first‐order conditional estimation method, where a one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. • Based on the developed model, pregabalin systemic exposure in patients with lower renal function (30 ≤ estimated creatinine clearance [CLcr] &lt;60 ml min−1) is expected to be similar to exposure in patients with normal renal function (CLcr≥60) administered twice the dose. • This study indicated that the systemic exposure of pregabalin could be adjusted with reference to the estimated proportional relationship between pregabalin apparent clearance and CLcr regardless of the disease. AIM Pregabalin, a chemical analogue of the mammalian neurotransmitter γ‐aminobutyric acid, has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and various other pain disorders, including neuropathic pain associated with post‐herpetic neuralgia and diabetic peripheral neuropathy and fibromyalgia. The aim of this study was to develop a population pharmacokinetic model and quantify the influence of covariates on the parameters. METHODS This pregabalin population pharmacokinetic analysis was conducted on data from 14 clinical trials involving healthy subjects, subjects with impaired renal function and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy (n= 616). The data analysis was performed using nonlinear mixed effects modelling methodology as implemented by NONMEM. RESULTS A one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. The model indicated that pregabalin apparent clearance (CL/F) was proportional to estimated creatinine clearance (CLcr). The pregabalin systemic exposure in patients with lower renal function who received pregabalin 150 mg twice daily was almost equal to that of patients with normal renal function administered pregabalin 300 mg twice daily. The systemic exposure stratified by lower or normal renal function was similar between patients with post‐herpetic neuralgia and diabetic peripheral neuropathy. CONCLUSION The developed model identified CLcr and ideal body weight as clinically influential covariates on CL/F and volume of distribution, respectively. This study indicates that renal function accounts for variability in the apparent clearance of pregabalin which is consistent with what is known about the elimination of this drug.</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesics - administration &amp; dosage</subject><subject>Analgesics - pharmacokinetics</subject><subject>Anxiety</subject><subject>Biological and medical sciences</subject><subject>Body weight</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Creatinine</subject><subject>Data processing</subject><subject>Diabetes mellitus</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Neuropathies - metabolism</subject><subject>diabetic peripheral neuropathy</subject><subject>Drugs</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Fibromyalgia</subject><subject>gamma -Aminobutyric acid</subject><subject>gamma-Aminobutyric Acid - administration &amp; dosage</subject><subject>gamma-Aminobutyric Acid - analogs &amp; derivatives</subject><subject>gamma-Aminobutyric Acid - pharmacokinetics</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Theoretical</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neuralgia</subject><subject>Neuralgia, Postherpetic - metabolism</subject><subject>Neurology</subject><subject>Neuropathy</subject><subject>Neurotransmitters</subject><subject>Pain</subject><subject>Peripheral neuropathy</subject><subject>Pharmacokinetics</subject><subject>Pharmacology. Drug treatments</subject><subject>population pharmacokinetics</subject><subject>Population studies</subject><subject>post‐herpetic neuralgia</subject><subject>Pregabalin</subject><subject>Renal function</subject><subject>Seizures</subject><subject>Viral diseases</subject><subject>Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye</subject><subject>Young Adult</subject><issn>0306-5251</issn><issn>1365-2125</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcuO0zAUhiMEYsrAKyBvkNgk-PiSywIkqLhJIzELWFsnjtO4pHGwE2a6Y8-GZ-RJcNpSYIdlyZfznd-_9ScJAZpBHM-2GfBcpgyYzBgFyCivOMtu7ySrc-FusqKc5qlkEi6SByFsKQUOubyfXDCIFQFylXy_duPc42TdQMYO_Q61-2wHM1kdiGvJ6M0Ga-ztQOLsDPZTtydhrrdGT4Hg0JAxdpshHm7s1JHRhenntx-d8eMiQgYze-w3FonzpLFYH25H4-0YGewPgIsa3f5hcq_FPphHp_Uy-fTm9cf1u_Tqw9v365dXqZY8Z6lgrM1FpaWWdcHq-HFZm8q0lINGbEGUrCxkLqHiJbSYV7KlVVk0jYikEAW_TF4cdce53plGR_PRiBq93aHfK4dW_VsZbKc27qviIADKReDpScC7L7MJk9rZoE3f42DcHBRQxmQOrGARLY-o9i4Eb9rzM0DVkqXaqiUytUSmlizVIUt1G1sf_23z3Pg7vAg8OQEYNPatx0Hb8IcTTIiqWLjnR-7G9mb_3wbUq_X1suO_AMc5vus</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>Shoji, Satoshi</creator><creator>Suzuki, Misaki</creator><creator>Tomono, Yoshiro</creator><creator>Bockbrader, Howard N.</creator><creator>Matsui, Shigeyuki</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Blackwell Science Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>201107</creationdate><title>Population pharmacokinetics of pregabalin in healthy subjects and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy</title><author>Shoji, Satoshi ; Suzuki, Misaki ; Tomono, Yoshiro ; Bockbrader, Howard N. ; Matsui, Shigeyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5362-422f649c5c5b72b9325be9ef031caaf14828756519381fa695f0987dd43254473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesics - administration &amp; dosage</topic><topic>Analgesics - pharmacokinetics</topic><topic>Anxiety</topic><topic>Biological and medical sciences</topic><topic>Body weight</topic><topic>Clinical trials</topic><topic>Clinical Trials as Topic</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Creatinine</topic><topic>Data processing</topic><topic>Diabetes mellitus</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Neuropathies - metabolism</topic><topic>diabetic peripheral neuropathy</topic><topic>Drugs</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Fibromyalgia</topic><topic>gamma -Aminobutyric acid</topic><topic>gamma-Aminobutyric Acid - administration &amp; dosage</topic><topic>gamma-Aminobutyric Acid - analogs &amp; derivatives</topic><topic>gamma-Aminobutyric Acid - pharmacokinetics</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Theoretical</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neuralgia</topic><topic>Neuralgia, Postherpetic - metabolism</topic><topic>Neurology</topic><topic>Neuropathy</topic><topic>Neurotransmitters</topic><topic>Pain</topic><topic>Peripheral neuropathy</topic><topic>Pharmacokinetics</topic><topic>Pharmacology. Drug treatments</topic><topic>population pharmacokinetics</topic><topic>Population studies</topic><topic>post‐herpetic neuralgia</topic><topic>Pregabalin</topic><topic>Renal function</topic><topic>Seizures</topic><topic>Viral diseases</topic><topic>Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shoji, Satoshi</creatorcontrib><creatorcontrib>Suzuki, Misaki</creatorcontrib><creatorcontrib>Tomono, Yoshiro</creatorcontrib><creatorcontrib>Bockbrader, Howard N.</creatorcontrib><creatorcontrib>Matsui, Shigeyuki</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shoji, Satoshi</au><au>Suzuki, Misaki</au><au>Tomono, Yoshiro</au><au>Bockbrader, Howard N.</au><au>Matsui, Shigeyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population pharmacokinetics of pregabalin in healthy subjects and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy</atitle><jtitle>British journal of clinical pharmacology</jtitle><addtitle>Br J Clin Pharmacol</addtitle><date>2011-07</date><risdate>2011</risdate><volume>72</volume><issue>1</issue><spage>63</spage><epage>76</epage><pages>63-76</pages><issn>0306-5251</issn><eissn>1365-2125</eissn><coden>BCPHBM</coden><abstract>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pregabalin has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and a wide variety of pain disorders. • Although pharmacokinetic studies have demonstrated that pregabalin apparent clearance is correlated with estimated creatinine clearance, quantitatively accurate estimation of this relationship is warranted for establishing clinical usage of this drug. WHAT THIS STUDY ADDS • A population pharmacokinetic model was developed from 14 pregabalin clinical trials using the first‐order conditional estimation method, where a one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. • Based on the developed model, pregabalin systemic exposure in patients with lower renal function (30 ≤ estimated creatinine clearance [CLcr] &lt;60 ml min−1) is expected to be similar to exposure in patients with normal renal function (CLcr≥60) administered twice the dose. • This study indicated that the systemic exposure of pregabalin could be adjusted with reference to the estimated proportional relationship between pregabalin apparent clearance and CLcr regardless of the disease. AIM Pregabalin, a chemical analogue of the mammalian neurotransmitter γ‐aminobutyric acid, has been approved in many countries for partial‐onset seizures, generalized anxiety disorder and various other pain disorders, including neuropathic pain associated with post‐herpetic neuralgia and diabetic peripheral neuropathy and fibromyalgia. The aim of this study was to develop a population pharmacokinetic model and quantify the influence of covariates on the parameters. METHODS This pregabalin population pharmacokinetic analysis was conducted on data from 14 clinical trials involving healthy subjects, subjects with impaired renal function and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy (n= 616). The data analysis was performed using nonlinear mixed effects modelling methodology as implemented by NONMEM. RESULTS A one‐compartment model with first‐order absorption and elimination adequately described pregabalin pharmacokinetics. The model indicated that pregabalin apparent clearance (CL/F) was proportional to estimated creatinine clearance (CLcr). The pregabalin systemic exposure in patients with lower renal function who received pregabalin 150 mg twice daily was almost equal to that of patients with normal renal function administered pregabalin 300 mg twice daily. The systemic exposure stratified by lower or normal renal function was similar between patients with post‐herpetic neuralgia and diabetic peripheral neuropathy. CONCLUSION The developed model identified CLcr and ideal body weight as clinically influential covariates on CL/F and volume of distribution, respectively. This study indicates that renal function accounts for variability in the apparent clearance of pregabalin which is consistent with what is known about the elimination of this drug.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21306415</pmid><doi>10.1111/j.1365-2125.2011.03932.x</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Analgesics - administration & dosage
Analgesics - pharmacokinetics
Anxiety
Biological and medical sciences
Body weight
Clinical trials
Clinical Trials as Topic
Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction
Creatinine
Data processing
Diabetes mellitus
Diabetes. Impaired glucose tolerance
Diabetic Neuropathies - metabolism
diabetic peripheral neuropathy
Drugs
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Fibromyalgia
gamma -Aminobutyric acid
gamma-Aminobutyric Acid - administration & dosage
gamma-Aminobutyric Acid - analogs & derivatives
gamma-Aminobutyric Acid - pharmacokinetics
Human viral diseases
Humans
Infectious diseases
Medical sciences
Middle Aged
Models, Theoretical
Nervous system (semeiology, syndromes)
Neuralgia
Neuralgia, Postherpetic - metabolism
Neurology
Neuropathy
Neurotransmitters
Pain
Peripheral neuropathy
Pharmacokinetics
Pharmacology. Drug treatments
population pharmacokinetics
Population studies
post‐herpetic neuralgia
Pregabalin
Renal function
Seizures
Viral diseases
Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
Young Adult
title Population pharmacokinetics of pregabalin in healthy subjects and patients with post‐herpetic neuralgia or diabetic peripheral neuropathy
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