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| 2. |
- Karlsson, Kristin C., et al.
(författare)
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A population pharmacokinetic model of gabapentin developed in nonparametric adaptive grid and nonlinear mixed effects modeling
- 2009
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Ingår i: Therapeutic Drug Monitoring. - 0163-4356 .- 1536-3694. ; 31:1, s. 86-94
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Tidskriftsartikel (refereegranskat)abstract
- Gabapentin is used in analgesic treatment of neuropathic pain, and large interindividual variation has been observed in the pharmacokinetics (PK) of the drug. The aim of this study was to develop a population PK model for gabapentin appropriate for monitoring patients with neuropathic pain and for individualizing their dose regimens. Steady-state serum concentrations of gabapentin, distributed over a dosage interval, were obtained from 16 adult patients. Data were analyzed with an iterative 2-stage Bayesian and a nonparametric adaptive grid algorithm (NPAG) (USC*PACK) and with nonlinear mixed effects modeling (NONMEM). Compartmental population models for gabapentin PK were developed in NPAG and NONMEM using creatinine clearance and body weight as covariates. Bioavailability was included in the models as a function of dose by using a hyperbolic function derived from data previously reported in the literature. The mean population parameter estimates from the final NPAG model predicted individual serum concentrations reasonably well. The models developed in NONMEM provided additional information about the relevance of the various possible covariates and also allowed for further evaluation by simulation from the model. The population PK model may be utilized in the MM-USCPACK monitoring software (MM: multiple model dosage design) for predicting and achieving individually optimized steady-state serum concentrations of gabapentin.
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| 3. |
- Karlsson, Kristin C., et al.
(författare)
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Modeling subpopulations with the $MIXTURE subroutine in NONMEM : finding the individual probability of belonging to a subpopulation for the use in model analysis and improved decision making
- 2009
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Ingår i: AAPS Journal. - : Springer. - 1550-7416. ; 11:1, s. 148-154
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Tidskriftsartikel (refereegranskat)abstract
- In nonlinear mixed effects modeling using NONMEM, mixture models can be used for multimodal distributions of parameters. The fraction of individuals belonging to each of the subpopulations can be estimated, and the most probable subpopulation for each patient is output (MIXEST(k)). The objective function value (OFV) that is minimized is the sum of the OFVs for each patient (OFV(i)), which in turn is the sum across the k subpopulations (OFV(i,k)). The OFV(i,k) values can be used together with the total probability in the population of belonging to subpopulation k to calculate the individual probability of belonging to the subpopulation (IP(k)). Our objective was to explore the information gained by using IP(k) instead of or in addition to MIXEST(k) in the analysis of mixture models. Two real data sets described previously by mixture models as well as simulations were used to explore the use of IP(k) and the precision of individual parameter values based on IP(k) and MIXEST(k). For both real data-based mixture models, a substantial fraction (11% and 26%) of the patients had IP(k) values not close to 0 or 1 (IP(k) between 0.25 and 0.75). Simulations of eight different scenarios showed that individual parameter estimates based on MIXEST were less precise than those based on IP(k), as the root mean squared error was reduced for IP(k) in all scenarios. A probability estimate such as IP(k) provides more detailed information about each individual than the discrete MIXEST(k). Individual parameter estimates based on IP(k) should be preferable whenever individual parameter estimates are to be used as study output or for simulations.
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| 4. |
- Karlsson, Kristin E., et al.
(författare)
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Randomized exposure-controlled trials : Impact of randomization and analysis strategies
- 2007
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Ingår i: British Journal of Clinical Pharmacology. - : Wiley. - 0306-5251 .- 1365-2125. ; 64:3, s. 266-277
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In the literature, five potential benefits of randomizing clinical trials on concentration levels, rather than dose, have been proposed: (i) statistical study power will increase; (ii) study power will be less sensitive to high variability in the pharmacokinetics (PK); (iii) the power of establishing an exposure-response relationship will be robust to correlations between PK and pharmacodynamics (PD); (iv) estimates of the exposure-response relationship are likely to be less biased; and (v) studies will provide a better control of exposure in situations with toxicity issues. The main aim of this study was to investigate if these five statements are valid when the trial results are evaluated using a model-based analysis. Methods: Quantitative relationships between drug dose, concentration, biomarker and clinical end-point were defined using pharmacometric models. Three randomization schemes for exposure-controlled trials, dose-controlled (RDCT), concentration-controlled (RCCT) and biomarker-controlled (RBCT), were simulated and analysed according to the models. Results: (i) The RCCT and RBCT had lower statistical power than RDCT in a model-based analysis; (ii) with a model-based analysis the power for an RDCT increased with increasing PK variability; (iii) the statistical power in a model-based analysis was robust to correlations between CL and EC 50 or Emax; (iv) under all conditions the bias was negligible (<3%); and (v) for studies with equal power RCCT could produce either more or fewer adverse events compared with an RDCT. Conclusion: Alternative randomization schemes may not have the proposed advantages if a model-based analysis is employed.
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| 5. |
- Magnusson, Mats O., 1975-
(författare)
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Pharmacodynamics of Enzyme Induction and its Consequences for Substrate Elimination
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Enzyme induction is a process whereby a molecule enhances the expression of enzymes. If the affected enzymes are involved in the elimination of a drug, this may result in a drug interaction. Induction is therefore of major concern during drug development and in clinical practice. The induction process depends on the half-life of the induced enzyme, the pharmacokinetics of the inducing agent, and the relationship between the inducer’s concentration and the induction stimulus. The aim of the conducted research was to investigate these key aspects of enzyme induction and the consequences that induction has for substrate elimination.Successful investigations of the induction process presuppose the existence of appropriate methods for the estimation of the metabolic activity. Enzyme activity measurements can be conducted in tissues with low enzyme content using the analytical method presented here. A model was developed describing the changes in the pharmacokinetics of clomethiazole and its metabolite NLA-715, that are attributable to carbamazepine induction. The consequences of the induction was explained using a mechanistic approach, acknowledging food-induced changes in the blood flow to the liver, and interpreting in vitro generated metabolic information.The time course of the induction process was examined in two investigations. In the first of these, the pharmacokinetics of the autoinducing drug phenobarbital and its effect on several enzymes were described in rats. This was accomplished by integrating the bidirectional interaction between drug and enzymes in a mechanistic manner. In the final investigation, the time course of the increase and cessation in enzyme activity was studied in healthy volunteers treated with carbamazepine. This investigation allowed the half-lives of CYP3A and CYP1A2 to be estimated. The key aspects of the enzyme induction process have been examined using mechanistic induction models. These novel models improve the understanding of the induction process and its consequences for substrate elimination.
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| 6. |
- Szamota-Leandersson, Karolina, et al.
(författare)
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Adsorption of Cs on InAs(111) surfaces
- 2006
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Ingår i: Applied Surface Science. - : Elsevier BV. - 0169-4332 .- 1873-5584. ; 252:15, s. 5267-5270
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Tidskriftsartikel (refereegranskat)abstract
- Caesiated InAs(111)B (1 x 1) and InAs(111)A (2 x 2) surfaces have been studied by photoelectron spectroscopy. On the InAs(111)B a new (root 3 x root 3)R30 degrees reconstruction was observed. During Cs evaporation remarkably small changes are observed in the lone pair states, and no sign of an accumulation layer at the surface can be observed. Instead, the additional charge provided by Cs is rapidly transported towards the bulk. On the InAs(111)A cesium behaves as a typical electropositive alkali metal donator that enhances the already existing accumulation layer.
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| 7. |
- Szamota-Leandersson, Karolina, et al.
(författare)
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Electronic structure of bismuth terminated InAs(100)
- 2009
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Ingår i: Surface Science. - : Elsevier BV. - 0039-6028 .- 1879-2758. ; 603:1, s. 190-196
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Tidskriftsartikel (refereegranskat)abstract
- Deposition of Bi onto (4 x 2)/c(8 x 2)-InAs(1 0 0) and subsequent annealing results in a (2 x 6) surface reconstruction as seen by low electron energy diffraction. The Bi condensation eliminates the original (4 x 2) Surface reconstruction and creates a new Structure including Bi-dimers. This Surface is metallic and hosts a charge accumulation layer seen through photoemission intensity near the Fermi level. The accumulation layer is located in the bulk region below the surface, but the intensity of the Fermi level structure is strongly dependent oil the Surface order.
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| 8. |
- Agnarsson, Björn, et al.
(författare)
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Influence of initial surface reconstruction on nitridation of Al2O3 (0001) using low pressure ammonia
- 2007
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 101:1, s. 013519-
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study is to investigate the effect of initial surface reconstruction on the nitridation process of Al2O3 (0001). This was done by exposing differently reconstructed sapphire substrates at different temperatures to low pressure ammonia (NH3). Structural and chemical analysis were carried out using low-electron energy diffraction and x-ray photoelectron spectroscopy. The experiments revealed that using low pressure ammonia (P-NH3 < 1 X 10(-5) Torr), no nitridation takes place on (1x1) unreconstructed surfaces. However, when the unreconstructed surface starts to change to a (root 31 x root 31) R +/- 9 degrees reconstructed surface, with increasing substrate temperature, the nitridation becomes successful. When using the initially reconstructed surface, the nitridation is successful even from the lowest temperature used. These results suggest that the initial surface reconstruction has a major effect on the nitridation process. This kinetic behavior has not been reported before, with most nitridation studies mainly focusing on the effect of surface temperature on the resulting surface morphology, rather than the actual kinetics of the process itself.
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| 9. |
- Ahn, Jae Eun, et al.
(författare)
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Likelihood based approaches to handling data below the quantification limit using NONMEM VI
- 2008
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Ingår i: Journal of Pharmacokinetics and Pharmacodynamics. - : Springer Science and Business Media LLC. - 1567-567X .- 1573-8744. ; 35:4, s. 401-421
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the likelihood-based methods for handling data below the quantification limit (BQL) using new features in NONMEM VI. METHODS: A two-compartment pharmacokinetic model with first-order absorption was chosen for investigation. Methods evaluated were: discarding BQL observations (M1), discarding BQL observations but adjusting the likelihood for the remaining data (M2), maximizing the likelihood for the data above the limit of quantification (LOQ) and treating BQL data as censored (M3), and like M3 but conditioning on the observation being greater than zero (M4). These four methods were compared using data simulated with a proportional error model. M2, M3, and M4 were also compared using data simulated from a positively truncated normal distribution. Successful terminations and bias and precision of parameter estimates were assessed. RESULTS: For the data simulated with a proportional error model, the overall performance was best for M3 followed by M2 and M1. M3 and M4 resulted in similar estimates in analyses without log transformation. For data simulated with the truncated normal distribution, M4 performed better than M3. CONCLUSIONS: Analyses that maximized the likelihood of the data above the LOQ and treated BQL data as censored provided the most accurate and precise parameter estimates.
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