蒙特卡洛模拟优化精神分裂症患者氨磺必利的维持给药方案
Optimizing maintenance dosing regimens of amsulpride in schizophrenics using Monte Carlo simulation
黄文灿 1陈金兰 1庄淑丽 1叶国兵 1庄小雁 1梁志鹏 1黄淑燕2
作者信息
- 1. 广州市民政局精神病院,药剂科,广东广州 510430
- 2. 广州市民政局精神病院,医务部,广东广州 510430
- 折叠
摘要
目的:运用蒙特卡洛模拟(Monte Carlo simulation,MCs)优化精神分裂症患者氨磺必利的维持给药方案.方法:基于已发表的氨磺必利在精神分裂症患者的群体药动学数据,利用MCs预测其在不同给药方案下稳态血药浓度(Css)及其推荐血药浓度参考范围100～600 ng·mL-1的达标概率(probability of target attainment,PTA),结合临床血药浓度监测结果进行验证.结果:当氨磺必利的给药方案分别为350～400 mg qd,150～300 mg bid,100～200 mg tid,Css分布于100～600 ng·mL-1的PTA＞90％.当日剂量≥1 050 mg时,Css很可能大于600ng·mL-1(模拟概率≥75.61％).24份常规剂量下氨磺必利血药浓度结果为48.10～1 032.03 ng·mL-1,均值为(466.64±284.10)ng·mL-1.结论:MCs可预测中国精神分裂症患者氨磺必利的Css及其处于治疗浓度参考范围的概率;根据临床治疗情况,常规剂量下将氨磺必利参考浓度范围设定为100～600 ng·mL-1具有合理性.
Abstract
OBJECTIVE To optimize the maintenance dosing regimen of amisulpride in schizophrenics using Monte Carlo simulations(MCs).METHODS Based upon the published population pharmacokinetic(PPK)data of amisulpride in schizo-phrenics,using MCs to predict its steady-state plasma concentration(Cs)and its recommended blood concentration reference range of 100-600 ng·mL-1 under different dosage regimens.Probability of target attainment(PTA)was applied along with monitoring clinical blood drug concentrations for verification.RESULTS When amisulpride was 350-400 mg qd,150-300 mg bid and 100-200 mg tid,PTA value of Css was＞90％in the range of 100-600 ng·mL-1.At a daily dose ≥1 050 mg,Cs was likely to surpass 600 ng·mL-1(simulation probability ≥75.61％).Blood concentration of amisulpride at a conventional dose in 24 samples was 48.10-1 032.03 ng·mL-1 with an average value of(466.64±284.10)ng·mL-1.CONCLUSION MCs may predict Css of amisulpride in Chinese schizophrenics.According to clinical treatment,it is reasonable to set the reference concentra-tion range of amisulpride at 100-600 ng·mL-1 under a conventional dose.
关键词
氨磺必利/蒙特卡洛模拟/稳态血药浓度/精神分裂症Key words
amisulpride/Monte Carlo simulation/steady-state plasma concentration/schizophrenia引用本文复制引用
基金项目
广州市康宁医院院内青年项目(KNQ2022003)
出版年
2024
NETL
NSTL
万方数据