Model-Informed Drug Development for Everolimus Dosing Selection in Pediatric Infant Patients.

CPT: Pharmacometrics & Systems Pharmacology
François Pierre CombesKai Grosch

Abstract

Everolimus is currently approved in Europe as an adjunctive therapy for patients aged ≥ 2 years with tuberous sclerosis complex (TSC)-associated treatment-refractory partial-onset seizures, based on the EXIST-3 study (NCT01713946) results. As TSC-associated seizures can also affect children aged between 6 months and 2 years, a modeling and simulation (M&S) approach was undertaken to extrapolate exposure (trough plasma concentration (Cmin )) after a dose of 6 mg/m2 and reduction in seizure frequency (RSF). A physiologically based pharmacokinetic model using Simcyp was developed to predict Cmin in adult and pediatric patients, which was then used by a population pharmacodynamic model and a linear mixed effect model to predict short-term and long-term efficacy in adults (for validation) and in children, respectively. Based on the results of the M&S study, everolimus at the dose of 6 mg/m2 is anticipated to be an efficacious treatment in children 6 months to 2 years of age (up to 77.8% RSF) with concentrations within the recommended target range.

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Citations

Mar 19, 2021·British Journal of Clinical Pharmacology·Brian D ChapronJ Steven Leeder

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Clinical Trials Mentioned

NCT01713946
NCT00789828
NCT00790400

Software Mentioned

PopPD
Simcyp
EXIST

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