Pediatric Population Pharmacokinetic Modeling and Exposure-Response Analysis of Ambrisentan in Pulmonary Arterial Hypertension and Comparison With Adult Data.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_CBE3CF25965C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pediatric Population Pharmacokinetic Modeling and Exposure-Response Analysis of Ambrisentan in Pulmonary Arterial Hypertension and Comparison With Adult Data.
Journal
Journal of clinical pharmacology
Author(s)
Okour M., Thapar M.M., Farrell C., Lukas M.A., Beghetti M., Beerahee M.
ISSN
1552-4604 (Electronic)
ISSN-L
0091-2700
Publication state
Published
Issued date
05/2023
Peer-reviewed
Oui
Volume
63
Number
5
Pages
593-603
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
This study aimed to develop a population pharmacokinetic (PK) model of ambrisentan in pediatric patients (8 to <18 years) with pulmonary arterial hypertension (PAH) and compare pediatric ambrisentan systemic exposure with previously reported adult data. Association of ambrisentan exposure with efficacy (6-minute walking distance) and safety (adverse events) were exploratory analyses. A population PK model was developed using pediatric PK data. Steady-state systemic exposure metrics were estimated for the pediatric population and compared with previously reported data in adult patients with PAH and healthy subjects. No covariates had a significant effect on PK parameters; therefore, the final covariate model was the same as the base model. The pediatric population PK model was a 2-compartment model including the effect of body weight (allometric scaling), first-order absorption and elimination, and absorption lag time. Steady-state ambrisentan exposure was similar between the pediatric and adult population when accounting for body weight differences. Geometric mean area under the concentration-time curve at steady state in pediatric patients receiving ambrisentan low dose was 3% lower than in the adult population (and similar in both populations receiving high dose). Geometric mean maximum plasma concentration at steady state in pediatric patients receiving low and high doses was 11% and 18% higher, respectively, than in the adult population. There was no apparent association in the pediatric or adult population between ambrisentan exposure and change in 6-minute walking distance or incidence of ambrisentan-related adverse events in pediatric patients. The similar ambrisentan exposure and exposure-response profiles observed in pediatric and adult populations with PAH suggests appropriateness of body-weight-based dosing in the pediatric population with PAH.
Keywords
Humans, Adult, Child, Pulmonary Arterial Hypertension/drug therapy, Pulmonary Arterial Hypertension/chemically induced, Antihypertensive Agents, Familial Primary Pulmonary Hypertension, Phenylpropionates/adverse effects, Phenylpropionates/pharmacokinetics, Pyridazines/adverse effects, Pyridazines/pharmacokinetics, 6-minute walking distance, ambrisentan, exposure-response, pediatrics, pharmacokinetic model, pulmonary arterial hypertension
Pubmed
Web of science
Open Access
Yes
Create date
10/01/2023 16:42
Last modification date
25/11/2023 8:20
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