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Development of population pharmacokinetics model and Bayesian estimation of rifampicin exposure in Indonesian patients with tuberculosis - 10/03/23

Doi : 10.1016/j.tube.2023.102325 
Soedarsono Soedarsono a, b, c, d, 1, , Rannissa Puspita Jayanti e, f, 1, Ni Made Mertaniasih c, d, g, Tutik Kusmiati a, c, d, Ariani Permatasari a, c, d, Dwi Wahyu Indrawanto a, d, Anita Nur Charisma a, d, Elvina Elizabeth Lius a, d, Rika Yuliwulandari h, i, Pham Quang Hoa e, f, Nguyen Ky Phat e, f, Vo Thuy Anh Thu e, Nguyen Ky Anh e, f, Sangzin Ahn e, f, Nguyen Phuoc Long e, f, Yong-Soon Cho e, f, , Jae-Gook Shin e, f, j
a Department of Pulmonology & Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, 60131, Indonesia 
b Sub-pulmonology Department of Internal Medicine, Faculty of Medicine, Hang Tuah University, Surabaya, 60244, Indonesia 
c Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60131, Indonesia 
d Dr. Soetomo General Hospital, Surabaya, 60131, Indonesia 
e Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, 47392, Republic of Korea 
f Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, 47392, Republic of Korea 
g Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, 60131, Indonesia 
h Department of Pharmacology, Faculty of Medicine, YARSI University, Jakarta, 10510, Indonesia 
i Genetic Research Center, YARSI Research Institute, YARSI University, Jakarta, 10510, Indonesia 
j Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan, 47392, Republic of Korea 

Corresponding author. Center for Personalized Precision Medicine of Tuberculosis, Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, 633-165, Gaegum-Dong, Jin-Gu Busan, 47392, Republic of Korea.Center for Personalized Precision Medicine of TuberculosisDepartment of Pharmacology and Pharmacogenomics Research CenterInje University College of Medicine633-165Gaegum-DongJin-GuBusan47392Republic of Korea∗∗Corresponding author. Department of Pulmonology & Respiratory Medicine Faculty of Medicine, Universitas Airlangga Jl. Mayjen Prof. Dr. Moestopo No. 47, Surabaya, 60131, Indonesia.Department of Pulmonology & Respiratory Medicine Faculty of MedicineUniversitas AirlanggaJl. Mayjen Prof. Dr. Moestopo No. 47Surabaya60131Indonesia

Abstract

Background

Interindividual variability in the pharmacokinetics (PK) of anti-tuberculosis (TB) drugs is the leading cause of treatment failure. Herein, we evaluated the influence of demographic, clinical, and genetic factors that cause variability in RIF PK parameters in Indonesian TB patients.

Methods

In total, 210 Indonesian patients with TB (300 plasma samples) were enrolled in this study. Clinical data, solute carrier organic anion transporter family member-1B1 (SLCO1B1) haplotypes *1a, *1b, and *15, and RIF concentrations were analyzed. The population PK model was developed using a non-linear mixed effect method.

Results

A one-compartment model with allometric scaling adequately described the PK of RIF. Age and SLCO1B1 haplotype *15 were significantly associated with variability in apparent clearance (CL/F). For patients in their 40s, each 10-year increase in age was associated with a 10% decrease in CL/F (7.85 L/h). Patients with the SLCO1B1 haplotype *15 had a 24% lower CL/F compared to those with the wild-type. Visual predictive checks and non-parametric bootstrap analysis indicated good model performance.

Conclusion

Age and SLCO1B1 haplotype *15 were significant covariates of RIF CL/F. Geriatric patients with haplotype *15 had significantly greater exposure to RIF. The model could optimize TB pharmacotherapy through its application in therapeutic drug monitoring (clinical trial no. NCT05280886).

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Highlights

LBW, age, and SLCO1B1 *15 were significantly associated with RIF PK variability.
Geriatric Indonesian TB patients had high exposure of RIF.
Sparse sampling at random post-dose time points enables good estimation of RIF PK.
SLCO1B1 *15 haplotype was associated with 24% lower clearance of RIF.

Le texte complet de cet article est disponible en PDF.

Keywords : Tuberculosis, Rifampicin, Pharmacogenetic, Population pharmacokinetics, Therapeutic drug monitoring


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Vol 139

Article 102325- mars 2023 Retour au numéro
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