Determination of optimal vitamin D3 dosing regimens in HIV‐infected paediatric patients using a population pharmacokinetic approach. (November 2014)

• Record Type: Journal Article
• Authors: Foissac, Frantz; Meyzer, Candice; Frange, Pierre; Chappuy, Hélène; Benaboud, Sihem; Bouazza, Naïm; Friedlander, Gérard; Souberbielle, Jean‐Claude; Urien, Saïk; Blanche, Stéphane; Tréluyer, Jean‐Marc
• Is Part Of: British journal of clinical pharmacology. Volume 78:Number 5(2014:Nov.)
• Page Start: 1113
• Page End: 1121
• Publication Date: 2014-11
• Subjects: Pharmacology -- Periodicals; Drugs -- Periodicals; 615.1
• DOI: 10.1111/bcp.12433
• Languages: English
• ISSNs: 0306-5251

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bcp12433-sec-0001" sec-type="section"> <title>Aims</title> <p>To investigate 25‐hydroxycholecalciferol [25(OH)D] population pharmacokinetics in children and adolescents, to establish factors that influence 25(OH)D pharmacokinetics and to assess different vitamin D<sub>3</sub> dosing schemes to reach sufficient 25(OH)D concentrations (>30 ng ml<sup>−1</sup>).</p> </sec> <sec id="bcp12433-sec-0002" sec-type="section"> <title>Methods</title> <p>This monocentric prospective study included 91 young HIV‐infected patients aged 3 to 24 years. Patients received a 100 000 IU vitamin D<sub>3</sub> supplementation. A total of 171 25(OH)D concentrations were used to perform a population pharmacokinetic analysis.</p> </sec> <sec id="bcp12433-sec-0003" sec-type="section"> <title>Results</title> <p>At baseline 28% of patients had 25(OH)D concentrations below 10 ng ml<sup>−1</sup>, 69% between 10 and 30 ng ml<sup>−1</sup> and 3% above 30 ng ml<sup>−1</sup>. 25(OH)D pharmacokinetics were best described by a one compartment model with an additional production parameter reflecting the input from diet and sun exposure. The effects of skin phototype and bodyweight were significant on 25(OH)D production before any supplementation. The basal level was 27% lower in non‐white skin phototype patients and was slightly decreased with bodyweight. No significant differences in 25(OH)D concentrations were related to antiretroviral drugs. To obtain concentrations between 30 and 80 ng ml<sup>−1</sup>, patients with baseline concentrations between 10 and 30 ng ml<sup>−1</sup> should receive 100 000 IU per 3 months. However, vitamin D deficient patients (<10 ng ml<sup>−1</sup>) would need an intensive phase of 100 000 IU per 2 weeks (two times) followed 2 weeks later by a maintenance phase of 100 000 IU per 3 months.</p> </sec> <sec id="bcp12433-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Skin phototype and bodyweight had an influence on the basal production of 25(OH)D. According to 25(OH)D baseline concentrations, dosing schemes to reach sufficient concentrations are proposed.</p> </sec> </abstract>