title: Applications of linking PBPK and PD models to predict the impact of genotypic variability, formulation differences, differences in target binding capacity and target site drug concentrations on drug responses and variability.
abstract: This study aimed to demonstrate the added value of integrating prior in vitro data and knowledge-rich physiologically based pharmacokinetic (PBPK) models with pharmacodynamics (PDs) models. Four distinct applications that were developed and tested are presented here. PBPK models were developed for metoprolol using different CYP2D6 genotypes based on in vitro data. Application of the models for prediction of phenotypic differences in the pharmacokinetics (PKs) and PD compared favorably with clinical data, demonstrating that these differences can be predicted prior to the availability of such data from clinical trials. In the second case, PK and PD data for an immediate release formulation of nifedipine together with in vitro dissolution data for a controlled release (CR) formulation were used to predict the PK and PD of the CR. This approach can be useful to pharmaceutical scientists during formulation development. The operational model of agonism was used in the third application to describe the hypnotic effects of triazolam, and this was successfully extrapolated to zolpidem by changing only the drug related parameters from in vitro experiments. This PBPK modeling approach can be useful to developmental scientists who which to compare several drug candidates in the same therapeutic class. Finally, differences in QTc prolongation due to quinidine in Caucasian and Korean females were successfully predicted by the model using free heart concentrations as an input to the PD models. This PBPK linked PD model was used to demonstrate a higher sensitivity to free heart concentrations of quinidine in Caucasian females, thereby providing a mechanistic understanding of a clinical observation. In general, permutations of certain conditions which potentially change PK and hence PD may not be amenable to the conduct of clinical studies but linking PBPK with PD provides an alternative method of investigating the potential impact of PK changes on PD.
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Manoranjenni
authors.initials: M
authors.lastname: Chetty
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Rose
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Khaled
authors.initials: K
authors.lastname: Abduljalil
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Nikunjkumar
authors.initials: N
authors.lastname: Patel
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Gaohua
authors.initials: G
authors.lastname: Lu
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Theresa
authors.initials: T
authors.lastname: Cain
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK.
authors.forename: Masoud
authors.initials: M
authors.lastname: Jamei
authors.affiliation: Simcyp Limited (a Certara Company), Blades Enterprise Centre Sheffield, UK ; Manchester Pharmacy School, University of Manchester Manchester, UK.
authors.forename: Amin
authors.initials: A
authors.lastname: Rostami-Hodjegan
keywords: CYP P450 genotypes and response; PBPK linked PD models; formulation effects on drug response; heart drug concentration and QTc; target site concentrations and response