Population Pharmacodynamic Modeling of Epoetin Alfa in End‐Stage Renal Disease Patients Receiving Maintenance Treatment Using Bayesian Approach. (29th September 2020)

• Record Type: Journal Article
• Authors: Nguyen, Ly Minh; Meaney, Calvin J.; Rao, Gauri G.; Panesar, Mandip; Krzyzanski, Wojciech
• Is Part Of: CPT: pharmacometrics & systems pharmacology. Volume 9:Number 10(2020)
• Page Start: 596
• Page End: 605
• Publication Date: 2020-09-29
• Subjects: Pharmacokinetics -- Periodicals; Pharmacology -- Periodicals; Pharmacokinetics; Periodicals; 615.05
• DOI: 10.1002/psp4.12556
• Languages: English
• ISSNs: 2163-8306

Abstract

Abstract : The ability to control dosage regimens of erythropoiesis‐stimulating agents (ESAs) to maintain a desired hemoglobin (HGB) target is still elusive. We utilized a Bayesian approach and informative priors to characterize HGB profiles, using simulated drug concentrations, in patients with end‐stage renal disease receiving maintenance doses of epoetin alfa. We also demonstrated an adaptive Bayesian method, applied to individual patients, to improve the accuracy of HGB predictions over time. The results showed that sparse HGB data from daily clinical practice were characterized successfully. The adaptive Bayesian method effectively improved the accuracy of HGB predictions by updating the individual model with new data accounting for within‐subject changes over time. The Bayesian approach presented leverages existing knowledge of the model parameters and has a potential utility in clinical practice to individualize dosage regimens of epoetin alfa and ESAs to achieve target HGB. Further studies are warranted to develop an application for practical use.