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Interest and efforts to use recombinant adeno-associated viruses (AAV) as gene therapy delivery tools to treat disease have grown exponentially. However, gaps in understanding of the pharmacokinetics/pharmacodynamics (PK/PD) and disposition of this modality exist. This position paper comes from the Novel Modalities Working Group (WG), part of the International Consortium for Innovation and Quality in Pharmaceutical Development (IQ). The pan-industry WG effort focuses on the nonclinical PK and clinical pharmacology aspects of AAV gene therapy and related bioanalytical considerations. Traditional PK concepts are generally not applicable to AAV-based therapies due to the inherent complexity of a transgene-carrying viral vector, and the multiple steps and analytes involved in cell transduction and transgene-derived protein expression. Therefore, we explain PK concepts of biodistribution of AAV-based therapies and place key terminologies related to drug exposure and PD in the proper context. Factors affecting biodistribution are presented in detail, and guidelines are provided to design nonclinical studies to enable a stage-gated progression to Phase 1 testing. The nonclinical and clinical utility of transgene DNA, mRNA, and protein analytes are discussed with bioanalytical strategies to measure these analytes. The pros and cons of qPCR vs. ddPCR technologies for DNA/RNA measurement and qualitative vs. quantitative methods for transgene-derived protein are also presented. Last, best practices and recommendations for use of clinical and nonclinical data to project human dose and response are discussed. Together, the manuscript provides a holistic framework to discuss evolving concepts of PK/PD modeling, bioanalytical technologies, and clinical dose selection in gene therapy. [ABSTRACT FROM AUTHOR]

The objective of the present work is to evaluate the ability of the radiolabeled PAMAM dendrimers (polyamidoamine) towards facilitating the delivery of an in‐house synthesized porphyrin derivative in the tumorous lesions to evaluate their candidature for possible application in endo‐radionuclide therapy. For this, PAMAM particles were conjugated with a porphyrin derivative namely, 5,10,15,20‐tetrakis‐(4‐carboxymethyleneoxyphenyl)porphyrin (STAP), synthesized in‐house following a two‐step reaction. The average number of porphyrin molecules loaded per PAMAM particle was evaluated using ultraviolet‐visible spectrophotometry and was found to be approximately 2. STAP conjugated PAMAM particles were further conjugated with p‐NCS‐benzyl‐DOTA (subsequently referred as DOTA) to facilitate radiolabeling with 177Lu. On an average, two p‐NCS‐benzyl‐DOTA molecules were observed to be attached per PAMAM‐STAP particle. DOTA‐PAMAM‐STAP conjugate was radiolabeled with 177Lu with a final radiochemical purity of >95%, which was determined by paper chromatography using two different mobile phases viz. 0.1 M sodium citrate buffer (pH 5.0) and 10 mM DTPA. Biological behavior of [177Lu]Lu‐DOTA‐PAMAM‐STAP conjugate was investigated in fibrosarcoma bearing Swiss mice model wherein accumulation of radiolabeled particles was observed in liver, GIT, spleen, and kidneys at 3 h post‐administration. However, accumulated activity exhibited rapid clearance from majority of the organs at 24 h post‐administration. [177Lu]Lu‐DOTA‐PAMAM‐STAP conjugate exhibited an appreciable uptake in tumor mass [6.09 ± 1.22 percentage injected activity/organ (% IA/organ)] at 3 h post‐administration (p.i.) which was found to reduce to 1.05 ± 0.13 % IA/organ at 24 h post‐administration. The results obtained in biodistribution studies were further corroborated through scintigraphic imaging performed in the same animal model. Despite of an appreciable accumulation in tumor mass, the lower retention of the [177Lu]Lu‐DOTA‐PAMAM‐STAP conjugate therein, at longer time point (24 h p.i.) may limit its possible potential as a radio‐therapeutic agent and indicates towards need for further structural manoeuvring to attain favorable in vivo performance. [ABSTRACT FROM AUTHOR]

Adopted guidelines reflect a harmonised European approach to a specific scientific issue and should reflect the most recent scientific knowledge. However, whilst EU regulations are mandatory for all member states and EU directives must be followed by national laws in line with the directive, EMA guidelines do not have legal force and alternative approaches may be taken, but these obviously require more justification. This new series of the BJCP, developed in collaboration with the EMA, aims to address this issue by providing an annotated version of some relevant EMA guidelines and regulatory documents by experts. Hopefully, this will help in promoting their diffusion and in opening a forum for discussion with our readers. [ABSTRACT FROM AUTHOR]

Purpose: This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients.Methods: Literature review and analysis were performed by Panel Members nominated by the endorsing organisations, European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/Pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association for Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) and International Society of Antimicrobial Chemotherapy (ISAC). Panel members made recommendations for whether TDM should be applied clinically for different antimicrobials/classes.Results: TDM-guided dosing has been shown to be clinically beneficial for aminoglycosides, voriconazole and ribavirin. For most common antibiotics and antifungals in the ICU, a clear therapeutic range has been established, and for these agents, routine TDM in critically ill patients appears meritorious. For the antivirals, research is needed to identify therapeutic targets and determine whether antiviral TDM is indeed meritorious in this patient population. The Panel Members recommend routine TDM to be performed for aminoglycosides, beta-lactam antibiotics, linezolid, teicoplanin, vancomycin and voriconazole in critically ill patients.Conclusion: Although TDM should be the standard of care for most antimicrobials in every ICU, important barriers need to be addressed before routine TDM can be widely employed worldwide. [ABSTRACT FROM AUTHOR]

Abstract: A simple, sensitive, selective and reproducible method based on liquid chromatography was developed for the determination of chloroquine (CQ) and its active plasma metabolite desethylchloroquine (DECQ) in finger-pricked capillary blood spot onto filter paper (DBS) and whole blood samples. Both were separated from the internal standard quinine on a reversed phase C18 column, with the mobile phase consisting of a mixture of 1% diethylamine, acetonitrile and methanol (20:55:25, v:v:v) running at a flow rate of 1.0ml/min. Retention times of QN, DECQ and CQ were 4.5, 5.7 and 6.4min, respectively. Ultraviolet detection was at the wavelength 256nm. Sample preparation was done by extraction with hexane and tert-butyl methyl ether (1:1, v:v). Good precision and accuracy were obtained for both within-day repeatability and day-to-day reproducibility. Limit of quantification (LOQ) for both CQ and DECQ was accepted as 50ng/ml using 80μl DBS sample and 25ng/ml using 150μl whole blood sample. The mean recoveries for CQ, DECQ and internal standard for both whole blood and DBS were between 74 and 87%. The method was successfully applied for a pharmacokinetic study of CQ and DECQ in patients with Plasmodium vivax. Excellence correlation (r =0.997) was observed between the analysis of both CQ and DECQ in paired whole blood and DBS samples. [Copyright &y& Elsevier]

A simple high-performance liquid chromatographic method for the simultaneous analysis of quinine and 3-hydroxyquinine in blood samples dried on filter paper is described. Sample preparation involves liquid–liquid extraction with toluene–butanol 75:25 (v/v) followed by evaporation. A reversed-phase liquid chromatography system with fluorescence detection was used. The limit of determination was 10 nM for both quinine and 3-hydroxyquinine and the recovery varied between 78 and 109%. The within- and between-assay coefficients of variation varied between 2–5% and 4–10%, respectively. No loss of either analyte occurred after storage for 2 months at room temperature or at 37 °C. This method for sampling has advantages that make it of great value for clinical and pharmacokinetic studies especially in remote regions where storage and transportation is problematic. [Copyright &y& Elsevier]

Purpose: This Position Paper aims to review and discuss the available data on therapeutic drug monitoring (TDM) of antibacterials, antifungals and antivirals in critically ill adult patients in the intensive care unit (ICU). This Position Paper also provides a practical guide on how TDM can be applied in routine clinical practice to improve therapeutic outcomes in critically ill adult patients.Methods: Literature review and analysis were performed by Panel Members nominated by the endorsing organisations, European Society of Intensive Care Medicine (ESICM), Pharmacokinetic/Pharmacodynamic and Critically Ill Patient Study Groups of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), International Association for Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) and International Society of Antimicrobial Chemotherapy (ISAC). Panel members made recommendations for whether TDM should be applied clinically for different antimicrobials/classes.Results: TDM-guided dosing has been shown to be clinically beneficial for aminoglycosides, voriconazole and ribavirin. For most common antibiotics and antifungals in the ICU, a clear therapeutic range has been established, and for these agents, routine TDM in critically ill patients appears meritorious. For the antivirals, research is needed to identify therapeutic targets and determine whether antiviral TDM is indeed meritorious in this patient population. The Panel Members recommend routine TDM to be performed for aminoglycosides, beta-lactam antibiotics, linezolid, teicoplanin, vancomycin and voriconazole in critically ill patients.Conclusion: Although TDM should be the standard of care for most antimicrobials in every ICU, important barriers need to be addressed before routine TDM can be widely employed worldwide. [ABSTRACT FROM AUTHOR]

Introduction. On the initiative of the General Board of the Polish Society of Epileptology a Working Group was established to develop an expert position on breastfeeding by women with epilepsy in Poland. Aim. To facilitate a unified and rational approach to breastfeeding for women with epilepsy. Methods. An ad hoc system was developed to classify available published evidence and expert opinions, which was used to evaluate recommendations on various aspects related to counselling, risk and safety of breastfeeding. Discussion and conclusions. This position paper provides an educational, practical and organizational aspects. It will allow for the introduction of a uniform protocol of conduct in Poland, which in turn will improve the safety of the mother and her child. [ABSTRACT FROM AUTHOR]

The incidence of pediatric drugs poses unique challenges due to the distinct corporal, pharmacokinetic, and pharmacodynamic characteristics of juveniles. Innovative methods are being developed to address these challenges and ensure the safety and efficacy of pediatric treatments. This paper investigates various approaches to improve pediatric drug handling, including the implementation of age-appropriate formulations, the use of advanced drug delivery systems, and the incorporation of real-world evidence and patient-centric models in clinical trials. Additionally, regulatory frameworks and procedures that support pediatric drug development are examined, emphasizing the roles of initiatives such as the Pediatric Research Equity Act (PREA) and the Best Pharmaceuticals for Children Act (BPCA) in the United States, as well as similar efforts in Europe and other regions. Emphasis is placed on collaborative efforts among key stakeholders: manufacturers, academia, regulatory bodies, and patient advocacy groups, to promote change and address unmet medical needs in pediatric populations. Furthermore, this paper discusses the potential of emerging technologies, particularly artificial intelligence and genomics, to transform pediatric drug development. By leveraging these innovative strategies, the pharmaceutical industry can enhance treatment outcomes for children and advance pediatric healthcare. [ABSTRACT FROM AUTHOR]

Pediatric drug expression presents different challenges and freedoms on account of the singular corporeal traits and enlightening stages of adolescents. Developing age-appropriate formulations makes necessary a deep understanding of pediatric pharmacokinetics and pharmacodynamics, in addition to the security and productiveness characterizations of cures. This paper surveys the standards and practices complicated in pediatric drug expression, stressing the significance of the portion of the drug or other consumable veracity, palatability, and ease of presidency. It reviews differing portions of drugs or other consumable forms, containing spoken fluids, capable of disintegration tablets, and tiny tablets, and focal points the act of excipients in guaranteeing balance and reputation. Additionally, this paper addresses supervisory directions and the importance of including pediatric subjects and caregivers in the expression process to embellish devotion and healing effects. By checking current progress and case studies, this paper underlines the distracting need for tailor-made pediatric formulations to correct pediatric healthcare conditions. Future guidance in pediatric drug expression is labeled, accompanying a devoted effort to change the way that 3D publication, novel childbirth methods, and embodied cure approaches. This paper aims to determine an inclusive survey of pediatric drug expression, contribution observations, and methods for optimizing drug analysis. [ABSTRACT FROM AUTHOR]

Developmental physiological changes occur throughout childhood, with important changes observed within the first few weeks and months from birth, potentially affecting drug pharmacokinetics. The impact of confounding factors in relation to the availability of clinically relevant and adequate drug formulations and administration devices is underestimated. Hence, it is important to highlight presently the relevance of formulation issues. Since 2007, the EU Paediatric Regulation enforces paediatric investigation plans in which the applicant has to justify the clinical relevance of each dosage form proposed in relation to age subsets involved and the suitability of administration modalities. Therefore, pediatric drug development has become more relevant, and the importance of using age-appropriate drug formulations has been acknowledged by investigators and other stakeholders. Palatability and acceptability assessment is considered to be important by the regulatory bodies as well as excipient safety and tolerability, as it can be an issue particularly in very young children. However, there remains a lack of research into pediatric biopharmaceutics (methodological input regarding in vitro tools and bridging studies). Clinical pharmacologists with expertise ranging from pharmacodynamics, pharmacokinetics, adverse drug effects, and toxicology should actively contribute in advancing drug formulation issues in children. [ABSTRACT FROM AUTHOR]

Effective and safe drug administration in young infants should be based on integrated knowledge concerning the evolving physiological characteristics of the infant who will receive the drug and the pharmacokinetic and pharmacodynamic characteristics of a given drug. Consequently, clinical pharmacology in neonates is as dynamic and diverse as the neonates we are entitled to take care of. Even more than median estimates, covariates of variability within the population are of clinical relevance. We aim to illustrate the complexity and the need for neonatal clinical pharmacology based on the gap between current and likely best clinical practice for two commonly administered compounds (aminoglycosides for infection and ibuprofen for patent ductus arteriosus) and one new compound (bevacizumab, to treat threshold retinopathy of prematurity). Progression has been made to render pharmacokinetic studies child size, e.g., low volume samples, optimal study design, and population pharmacokinetics. Challenges to further improve clinical pharmacology in neonates include, when appropriate, the validation of off-patent drug dosing regimens and of infant-tailored formulations. Knowledge integration, i.e., the use of available data to improve current drug use and to predict pharmacokinetics/pharmacodynamics for similar compounds is needed. Development of clinical research networks is helpful to achieve these goals. [ABSTRACT FROM AUTHOR]

Why not consider liquid salt forms of active pharmaceutical ingredients (APIs) as an alternative versatile tool in the pharmaceutical industry? Recent developments have shown that known APIs can be readily converted into ionic liquids and that these novel phases often possess different properties (e.g., improved solubilities and dissolution rates), which may have a direct impact on the pharmacokinetics and pharmacodynamics of the drug. They may also offer the potential of novel and more efficient delivery modes, as well as patent protection for each of the new forms of the drug. Since these pharmaceutically active ionic liquids represent a thermodynamically stable phase, they avoid the troublesome issues surrounding polymorphism and “polymorphic transformation.” In some cases, an active cation and an active anion can be combined to produce a liquid possessing dual functionality. Here we examine and challenge the current industry reliance on crystalline APIs by discussing the breadth and potential impact of liquid salts as a possible approach to phase control. [ABSTRACT FROM AUTHOR]

Although no randomized studies have demonstrated a positive impact of therapeutic drug monitoring (TDM) on clinical outcome in epilepsy, evidence from nonrandomized studies and everyday clinical experience does indicate that measuring serum concentrations of old and new generation antiepileptic drugs (AEDs) can have a valuable role in guiding patient management provided that concentrations are measured with a clear indication and are interpreted critically, taking into account the whole clinical context. Situations in which AED measurements are most likely to be of benefit include (1) when a person has attained the desired clinical outcome, to establish an individual therapeutic concentration which can be used at subsequent times to assess potential causes for a change in drug response; (2) as an aid in the diagnosis of clinical toxicity; (3) to assess compliance, particularly in patients with uncontrolled seizures or breakthrough seizures; (4) to guide dosage adjustment in situations associated with increased pharmacokinetic variability (e.g., children, the elderly, patients with associated diseases, drug formulation changes); (5) when a potentially important pharmacokinetic change is anticipated (e.g., in pregnancy, or when an interacting drug is added or removed); (6) to guide dose adjustments for AEDs with dose-dependent pharmacokinetics, particularly phenytoin. [ABSTRACT FROM AUTHOR]

Per the well‐known resistance of hepatitis B virus to nucleoside/nucleotide analogs, alternative treatment options with higher resistance barriers have been approved for use in both treatment‐naïve and lamivudine‐resistant hepatitis B virus infections. This phase I study was conducted in adults with normal and impaired renal function to evaluate the effect of renal impairment on the pharmacokinetics of besifovir, a prodrug of an acyclic nucleotide phosphonate, that is mainly cleared via renal excretion. An open‐label, single‐dose parallel‐group clinical study was conducted in subjects with normal renal function and mild, moderate, and severe renal impairment. Subjects received a single oral dose of besifovir dipivoxil 150 mg, and serial blood and urine samples were collected for up to 72 hours after dosing to assess the pharmacokinetic characteristics of besifovir. The extent of plasma exposure of besifovir, detected as its major and active metabolites, LB80331 and LB80317, respectively, increased with worsening renal function. Compared to the subjects with normal renal function, the mean areas under the concentration‐time curves of LB80331 increased by 1.5‐, 2.5‐, and 4.5‐fold in subjects with mild, moderate, and severe impairment, respectively. LB80317 showed a 1.8‐, 3.2‐, and 6.2‐fold increase in subjects with mild, moderate, and severe renal impairment compared to those with normal function. The ratios of LB80331 renal clearance and the average estimated glomerular filtration rate of each renal impairment group with respect to the normal group were similar. The increase in plasma exposure and decrease in renal clearance suggest the need to adjust dosage regimens in patients with moderate to severe renal impairment. [ABSTRACT FROM AUTHOR]

Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders (70%) after 3 weeks, and in 20 of 22 responders (91%) after 5 weeks of treatment. Reduction of M protein continued for 3 months and further decline was observed in only four patients. The Hb concentration showed a different time course, with a significant increase after 3 months and further increases continued for up to 12 months. Blood concentration levels of thalidomide from 40 patients were used to evaluate the pharmacokinetics of the drug. Rate of absorption, rate of elimination, volume of distribution, clearance and elimination half-life were calculated to be 0·200/h, 0·140/h, 0·886 l/kg, 0·126 l/h/kg and 4·98 h respectively. We found no relationship between thalidomide concentration and effect after 12 weeks. [ABSTRACT FROM AUTHOR]

Pregnant and breastfeeding women are often under-represented in clinical research, including pharmacokinetic studies, due to ethical and logistical challenges. This paper examines strategies to improve the recruitment and retention of this demographic in pharmacokinetic research, drawing on experiences from five studies conducted at the Infectious Diseases Institute, Makerere University, Uganda. Key strategies implemented include Community Advisory Board meetings, the involvement of Peer Mothers as Co-Investigators, established recruitment sites, the use of safety protocols, and the utilization of diverse communication platforms, including social media and stakeholder meetings. Despite these efforts, substantial barriers, such as scheduling conflicts and frequent staff turnover at recruitment sites, continue to threaten progress. The paper recommends flexible scheduling, strengthening public engagement, and transparent demonstration of adherence to ethical principles; justice, non-maleficence, respect, and beneficence to ensure the safety and inclusivity of pregnant and breastfeeding women. The inclusion of this population in pharmacokinetic studies is essential for providing evidence-based care that meets their unique health needs. [ABSTRACT FROM AUTHOR]

The article focuses on various research papers on equine including a study on cranial nuchal bursitis, the pharmacokinetics of the anticonvulsant levetiracetam in neonatal foals and interobserver variation while performing neurological examinations in horses. A study on insulin responses to standard dosed oral glucose tests (OGTs) is also analyzed.

Introduction and aim. Lung cancer is a major public health concern around the world and is responsible for a significant number of deaths. Most lung cancers are detected in advanced stages due to a lack of early-stage diagnosis, limiting the available therapeutic options. Unfortunately, conventional lung cancer treatments are frequently linked with side effects because they are not target-specific and can also harm neighboring healthy body cells. Nanotechnology has the potential to significantly add to the development of differentiated products and the improvement of patient outcomes. Clinical research has shown that nanomedicines enhance the pharmacokinetics and biodistribution of therapeutic agents while lowering their systemic toxicity. The objective of this review was to provide a summary of the current research on nanomedicines that have been clinically approved for the treatment of lung cancer. Material and methods. In February 2023, a PubMed literature search was conducted. The phrase "nanomedicines in lung cancer" was entered into the PubMed search engine. Articles published within the last five years were taken into account. To determine eligibility, the abstract of each study was reviewed. Finally, the full texts of selected articles were obtained and reviewed. Analysis of literature. The analysis of the literature revealed that nanomedicines offer significant advantages in lung cancer treatment, including improved pharmacokinetics, enhanced drug targeting to tumor tissues, and reduced systemic toxicity. However, further research is warranted to fully realize the potential of nanomedicines and optimize their clinical application. This analysis provides valuable insights into the current state of knowledge and highlights the need for continued exploration in this promising field of research. Conclusion. In summary, nanomedicine precisely targets tumor tissue and delivers drugs in a controlled and efficient manner. This is a novel strategy to overcome the existing limitations in the treatment of lung cancer. Further research is needed in this field as it is a promising area of lung cancer treatment. [ABSTRACT FROM AUTHOR]

Monoclonal antibodies (mAbs) have been extensively developed over the past few years, for the treatment of various inflammatory diseases. They are large molecules characterized by complex pharmacokinetic and pharmacodynamic properties. Therapeutic drug monitoring (TDM) is routinely implemented in the therapy with mAbs, to monitor patients' treatment response and to further guide dose adjustments. Serum has been the matrix of choice in the TDM of mAbs and its sampling requires the visit of the patients to laboratories that are not always easily accessible. Therefore, dried blood spots (DBS) and various microsampling techniques have been suggested as an alternative. DBS is a sampling technique in which capillary blood is deposited on a special filter paper. It is a relatively simple procedure, and the patients can perform the home-sampling. The convenience it offers has enabled its use in the quantification of small-molecule drugs, whilst in the recent years, studies aimed to develop microsampling methods that will facilitate the TDM of mAbs. Nevertheless, hematocrit still remains an obstacle that hinders a more widespread implementation of DBS in clinical practice. The introduction of novel analytical techniques and contemporary microsampling devices can be considered the steppingstone to the attempts made addressing this issue. [ABSTRACT FROM AUTHOR]

Background: Parachuting, also called bombing, is a way to ingest psychoactive substances wrapped into cigarette paper, toilet paper, etc. There is little data describing parachuting in terms of substances use, context of use and, most importantly, the motivations for using such wrappers, although some authors hypothesized that parachute could be used for pharmacokinetic reason. However, inconsistently, some authors report that parachutes are used for sustained-release whereas others report that users are looking for an immediate effect.Research Design and Methods: Considering parachute as a "home-made" dosage form, we have applied the dissolution testing to characterize the dissolution performance of a substance wrapped into a parachute and to characterize whether a parachute represents an immediate-release form or not.Results: This in-vitro study provides the first pharmacokinetic data for drugs wrapped in parachutes. It shows that parachute acts as sustained-release form when made with a cigarette paper wrapper, but as immediate release form in the presence of alcohol or if wrapped with toilet paper.Conclusions: An important message to harm reduction is that users must be aware that a parachute can have unexpected pharmacokinetics and have to avoid taking another parachute in the absence of an immediate-effect to avoid overdose. [ABSTRACT FROM AUTHOR]

Alpinae oxyphyllae fructus (AOF), the dried mature fruit of Alpinia oxyphylla Miquel of the Zingiberaceae family, shows many special pharmacological effects. In recent years, there has been an abundance of research results on AOF. In this paper, the new compounds isolated from AOF since 2018 are reviewed, including terpenes, flavonoids, diarylheptanoids, phenolic acid, sterols, alkanes, fats, etc. The isolation methods that were applied include the microwave-assisted method, response surface method, chiral high-performance liquid chromatography–multiple reaction monitoring–mass spectrometry (HPLC-MRM-MS) analytical method, ultra-high-performance liquid chromatography–quadrupole–electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Orbitrap-HRMS) method, ultra-high-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) method, hot water leaching method, ethanol leaching method, and so on. Additionally, the pharmacological effects of AOF found from 2018 to 2024 are also summarized, including neuroprotection, regulation of metabolic disorders, antioxidant activity, antiapoptosis, antiinflammatory activity, antidiabetic activity, antihyperuricemia, antiaging, antidiuresis, immune regulation, anti-tumor activity, renal protection, hepatoprotection, and anti-asthma. This paper provides a reference for further research on AOF. [ABSTRACT FROM AUTHOR]

Introduction: Traditionally, health ministries implement mass drug administration programmes for each neglected tropical disease (NTD) as separate and distinct campaigns. Many NTDs have overlapping endemicity suggesting co-administration might improve programme reach and efficiency, helping accelerate progress towards 2030 targets. Safety data are required to support a recommendation to undertake co-administration. Methodology: We aimed to compile and summarize existing data on co-administration of ivermectin, albendazole and azithromycin, including both data on pharmacokinetic interactions and data from previous experimental and observational studies conducted in NTD-endemic populations. We searched PubMed, Google Scholar, research and conference abstracts, gray literature, and national policy documents. We limited the publication language to English and used a search period from January 1st, 1995 through October 1st, 2022. Search terms were: azithromycin and ivermectin and albendazole, mass drug administration co-administration trials, integrated mass drug administration, mass drug administration safety, pharmacokinetic dynamics, and azithromycin and ivermectin and albendazole. We excluded papers if they did not include data on co-administration of azithromycin and both albendazole and ivermectin, or azithromycin with either albendazole or ivermectin alone. Results: We identified a total of 58 potentially relevant studies. Of these we identified 7 studies relevant to the research question and which met our inclusion criteria. Three papers analyzed pharmacokinetic and pharmacodynamic interactions. No study found evidence of clinically significant drug-drug interactions likely to impact safety or efficacy. Two papers and a conference presentation reported data on the safety of combinations of at least two of the drugs. A field study in Mali suggested the rates of adverse events were similar with combined or separate administration, but was underpowered. A further field study in Papua New Guinea used all three drugs as part of a four-drug regimen also including diethylcarbamazine; in this setting, co-administration appeared safe but there were issues with the consistency in how adverse events were recorded. Conclusion: There are relatively limited data on the safety profile of co-administering ivermectin, albendazole and azithromycin as an integrated regimen for NTDs. Despite the limited amount of data, available evidence suggests that such a strategy is safe with an absence of clinically important drug-drug interactions, no serious adverse events reported and little evidence for an increase in mild adverse events. Integrated MDA may be a viable strategy for national NTD programmes. Author summary: Treatment of the whole community (mass drug administration, MDA) has been a major intervention strategy against many neglected tropical diseases (NTDs) over the last decade. Normally health ministries deliver individual MDA rounds targeting specific NTDs. This multiplies the training, transport and time burden for local health service personnel in districts in which several NTDs are present, imposing considerable financial and human resource costs to health ministries and their partners, and causing requiring repeated disruption to the daily life of communities receiving MDA. Delivering MDA for several NTDs at one time could improve the efficiency of NTD programmes. We reviewed existing data on the safety and feasibility of combining MDA of albendazole, ivermectin and azithromycin into a single co-delivered MDA. Several studies had evaluated if taking these drugs at the same time changed drug levels in recipients' blood; these studies concluded that there was not an important difference in blood drug levels comparing instances when the medicines were taken separately to instances when they were taken at the same time. Two non-randomised studies assessed side effects experienced by people taking combinations of the three drugs and suggested doing so was safe. One small study in Mali had assessed combining all three drugs and also suggested this was safe but was too small to give a definitive answer. Two studies in Papua New Guinea assessed all three drugs being taken together in combination with a fourth drug, diethylcarbamazine. These studies also suggest co-administration was safe overall. Most of the identified studies had some methodological shortcomings, such as small sample sizes or issues with the way adverse events were recorded. Overall, the data suggest co-administration of azithromycin, ivermectin and albendazole is viable, but larger safety studies are needed. [ABSTRACT FROM AUTHOR]

Background and objective: During the drug development process, phase I trials are the first occasion to study the pharmacokinetics of a drug. They are performed in healthy subjects, or in patients in oncology, and are designed to determine a safe and acceptable dose for the later phases of clinical trials. We performed a bibliographic survey to investigate the way pharmacokinetics are described and reported in phase I clinical trials. Methods: We performed a MEDLINE search to retrieve the list of papers published between 2005 and 2006 and reporting phase I clinical trials with a pharmacokinetic study. We used a spreadsheet to record general information concerning the study and specific information regarding the pharmacokinetics, such as the sampling times, number of subjects and method of analysis. Results: The search yielded 349 papers, of which 37 were excluded for various reasons. Nearly all of the papers in our review concerned cancer studies, although this was not a requirement in the search. Consistent with the selection process, 84% papers explicitly stated pharmacokinetics as an objective of the study. The methods section usually included a description of the pharmacokinetics (88%), but 10% of the papers provided no information concerning the methods used for the pharmacokinetics and in 2%the description was only partial. The analytical method was usually basic, with non-compartmental or purely descriptive methods. Observed concentrations and areas under the concentration-time curves were the pharmacokinetic variables most often reported. The results of the pharmacokinetic study were frequently reported in a separate paragraph of the results section, and only 22% of the studies related the pharmacokinetic findings to other results from the study, such as toxicity or efficacy. In addition, important information such as the number of subjects included in the pharmacokinetic study or the pharmacokinetic sampling scheme was sometimes not reported explicitly. Conclusion: Concerns about the decreasing cost-effectiveness of the drug development process prompted the regulatory authorities to recently recommend better integration of all available information -- including, in particular, pharmacokinetics -- in this process. In our review, we found that this information was often either missing or incomplete, which hinders that objective. We suggest several improvements in the design and the reporting of the methods and results of these studies, to ensure that all relevant information has been included. Pharmacokinetic findings should also be integrated into the broader perspective of drug development, through the study of their relationship with toxicity and/or efficacy, even in the early phase I stages. [ABSTRACT FROM AUTHOR]

Abstract: The derivation of reference concentrations (RfCs) for systemically acting volatile organic chemicals (VOCs) uses a default factor of 10 to account for the interindividual variability in pharmacokinetics (PK) and pharmacodynamics (PD). The magnitude of the PK component of the interindividual variability factor (IVF; also referred to as human kinetic adjustment factor (HKAF)) has previously been estimated using Monte Carlo approaches and physiologically based pharmacokinetic (PBPK) models. Since the RfC derivation considers continuous lifetime human exposure to VOCs in the environment, algorithms to compute steady-state internal dose (SS-ID), such as steady-state arterial blood concentration (Ca) and the steady-state rate of amount metabolized (RAM), can be used to derive IVF-PKs. In this context, probability-bounds (P-bounds) approach is potentially useful for computing an interval of probability distribution of SS-ID from knowledge of population distribution of input parameters. The objective of this study was therefore to compute IVF-PK using the P-bounds approach along with an algorithm for SS-ID in an adult population exposed to VOCs. The existing steady-state algorithms, derived from PBPK models, were rewritten such that SS-ID could be related, without any interdependence, to the following input parameters: alveolar ventilation (Qp), hepatic blood flow (Ql), intrinsic clearance (CLint) and blood:air partition coefficient (Pb). The IVF-PK was calculated from the P-bounds of SS-ID corresponding to the 50th and 95th percentiles. Following either specification of probability distribution-free bounds (characterized by minimal, maximal, and mean values) or distribution-defined values (mean, standard deviation and shape of probability distribution where: Qp=lognormal, Ql=lognormal, CLint =lognormal and Pb=normal) in RAMAS Risk Calc® software version 3.0 (Applied Biomathematics, Setauket, NY), the P-bound estimates of SS-ID for benzene, carbon tetrachloride, chloroform and methyl chloroform were obtained for low level exposures (1ppm). Using probability distribution-defined inputs, the IVF-PK for benzene, carbon tetrachloride, chloroform and methyl chloroform were, respectively, 1.18, 1.28, 1.24, and 1.18 (based on P-bounds for Ca), and 1.31, 1.58, 1.30, and 1.24 (based on P-bounds for RAM). A validation of the P-bounds computation was performed by comparing the results with those obtained using Monte Carlo simulation of the steady-state algorithms. In data-poor situations, when the statistical distributions for all input parameters were not known or available, the P-bounds approach allowed the estimation of IVF-PK. The use of P-bounds method along with steady-state algorithms, as done in this study for the first time, is a practical and scientifically sound way of computing IVF-PKs for systemically acting VOCs. [Copyright &y& Elsevier]

A general review is presented of the roles of QSARs and mass balance models as tools for assessing the environmental fate and effects of chemicals of commerce. It is argued that all such chemicals must be assessed using a consistent and transparent methodology that uses chemical property data derived from QSARs, or experimental determinations when possible and applies evaluative or region-specific environmental models. These data and models enable an assessment to be made of the key chemical features of persistence, bioaccumulation, potential for long-range transport and toxicity. The other key feature is quantity used or discharged to the environment. A taxonomy of environmental models is presented in which it is suggested that rather than develop a single comprehensive model, the aim should be to establish a set of coordinated and consistent models treating evaluative and real environmental systems at a variety of scales from local to global and including food web models, organism-specific models and human exposure and pharmacokinetic models. The concentrations derived from these models can then be compared with levels judged to be of toxic significance. A brief account is given of perceived QSAR needs in terms of partitioning, reactivity, transport and toxicity data to support these models. [ABSTRACT FROM AUTHOR]

Oritavancin (ORI) is a semisynthetic lipoglycopeptide approved as a single 1200 mg dose intravenous infusion for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) caused by Gram-positive organisms in adults. The pharmacokinetic/pharmacodynamic (PK/PD) linear kinetic profile and long terminal half-life (~393 h) of ORI make it therapeutically attractive for the treatment of other Gram-positive infections for which prolonged therapy is needed. Multidose regimens are adopted in real-world clinical practice with promising results, but aggregated efficacy data are still lacking. A comprehensive search on PubMed/Medline, Scopus, Cochrane and Google Scholar databases was performed to include papers published up to the end of January 2023. All articles on ORI multiple doses usage, including case reports, with quantitative data and relevant clinical information were included. Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality. Differences in opinion were adjudicated by a third party. From 1751 potentially relevant papers identified by this search, a total of 16 studies met the inclusion criteria and were processed further in the final data analysis. We extracted data concerning clinical response, bacteriologic response, mortality and adverse events (AEs). From the 16 included papers, 301 cases of treatment with multidose ORIs were identified. Multidose regimens comprised an initial ORI dose of 1200 mg followed by 1200 mg or 800 mg subsequent doses with a varying total number and frequency of reinfusions. The most often treated infections and isolates were osteomyelitis (148; 54.4%), ABSSSI (35; 12.9%) and cellulitis (14; 5.1%); and MRSA (121), MSSA (66), CoNS (17), E. faecalis (13) and E. faecium (12), respectively. Clinical cure and improvement by multidose ORI regimens were observed in 85% (231/272) and 8% (22/272) patients, respectively. Multidose ORI was safe and well tolerated; the most frequent AEs were infusion-related reactions and hypoglycemia. A multidose ORI regimen may be beneficial in treating other Gram-positive infections besides ABSSSIs, with a good safety profile. Further studies are warranted to ascertain the superiority of one multidose ORI scheme or posology over the other. [ABSTRACT FROM AUTHOR]

To systematically assess the ChatGPT large language model on diverse tasks relevant to pharmacokinetic data analysis. ChatGPT was evaluated with prototypical tasks related to report writing, code generation, non-compartmental analysis, and pharmacokinetic word problems. The writing task consisted of writing an introduction for this paper from a draft title. The coding tasks consisted of generating R code for semi-logarithmic graphing of concentration–time profiles and calculating area under the curve and area under the moment curve from time zero to infinity. Pharmacokinetics word problems on single intravenous, extravascular bolus, and multiple dosing were taken from a pharmacokinetics textbook. Chain-of-thought and problem separation were assessed as prompt engineering strategies when errors occurred. ChatGPT showed satisfactory performance on the report writing, code generation tasks and provided accurate information on the principles and methods underlying pharmacokinetic data analysis. However, ChatGPT had high error rates in numerical calculations involving exponential functions. The outputs generated by ChatGPT were not reproducible: the precise content of the output was variable albeit not necessarily erroneous for different instances of the same prompt. Incorporation of prompt engineering strategies reduced but did not eliminate errors in numerical calculations. ChatGPT has the potential to become a powerful productivity tool for writing, knowledge encapsulation, and coding tasks in pharmacokinetic data analysis. The poor accuracy of ChatGPT in numerical calculations require resolution before it can be reliably used for PK and pharmacometrics data analysis. [ABSTRACT FROM AUTHOR]

In the realm of pharmaceutical advancement, the transformative prowess of nanotechnology shines through its precision-targeted drug delivery and amplified therapeutic effects. This paper ventures into the realm of radiolabeling techniques for unraveling the intricate choreography of drug kinetics within the bloodstream which encompass the delicate stages of absorption, distribution, metabolism, and excretion. Through the magical lens of the radiolabel, a real-time spectacle unfolds, providing invaluable insights into the safety and efficacy of nanomedicine interventions. Amid the labyrinthine complexities of drug-organism interactions and the lack of universal protocols for nanomedicine preparation, radiolabeling technology has emerged as a guiding constellation. The paper systematically assesses the methods commonly employed for pharmacokinetic studies, delves into the manifold advantages and techniques of radiolabel methods within the nanomedicine landscape, closely examines their application across a spectrum of pharmacokinetic studies and thoughtfully addresses the challenges they may pose. Embark on this illuminating odyssey--a journey that peers into the microcosm of nanomedicine, deciphering its dynamic interplay within the bloodstream through the luminary insights of radiolabeled tracing techniques. [ABSTRACT FROM AUTHOR]

Ivacaftor is the first potentiator of the cystic fibrosis transmembrane conductance regulator (CFTR) protein approved for use alone in the treatment of cystic fibrosis (CF). Ivacaftor is primarily metabolized by CYP3A4 and therefore may interact with drugs that are CYP3A4 substrates, resulting in changes in plasma exposure to ivacaftor. The study determined the levels of ivacaftor and its active metabolite M1 by ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). We screened 79 drugs and 19 severely inhibited ivacaftor metabolism, particularly two cardiovascular drugs (nisoldipine and nimodipine). In rat liver microsomes (RLM) and human liver microsomes (HLM), the half-maximal inhibitory concentrations (IC50) of nisoldipine on ivacaftor metabolism were 6.55 μM and 9.10 μM, respectively, and the inhibitory mechanism of nisoldipine on ivacaftor metabolism was mixed inhibition; the IC50 of nimodipine on ivacaftor metabolism in RLM and HLM were 4.57 μM and 7.15 μM, respectively, and the inhibitory mechanism of nimodipine on ivacaftor was competitive inhibition. In pharmacokinetic experiments in rats, it was observed that both nisoldipine and nimodipine significantly altered the pharmacokinetic parameters of ivacaftor, such as AUC(0-t) and CLz/F. However, this difference may not be clinically relevant. In conclusion, this paper presented the results of studies investigating the interaction between these drugs and ivacaftor in vitro and in vivo. The objective is to provide a rationale for the safety of ivacaftor in combination with other drugs. [ABSTRACT FROM AUTHOR]

The introduction of a new psychopharmaceutical medication instead of the previous one always poses a certain challenge. In the case of antipsychotics (AP), these problems are considerably more complicated and are mainly caused by the question of dose equivalents, but also by the pharmacokinetic properties of the drug. In the case of partial dopamine D2 agonists, an additional issue is the possibility of deterioration when switching from the previous D2 antagonists to these drugs. Cross-titration is therefore generally recommended. Finally, due to the capsule form, it is not possible to increase the dose of cariprazine by less than 1.5 mg during titration. In this paper, we have presented our proposal to replace the most commonly used second-generation APs with the third-generation AP cariprazine. We have taken into account the dose equivalents, the pharmacological forms of the drugs and their pharmacokinetic and pharmacodynamic properties. [ABSTRACT FROM AUTHOR]

In this study, a physiologically based pharmacokinetic (PBPK) modeling framework was employed to explore infliximab exposure following intravenous (5 mg/kg) and subcutaneous administration (encompassing the approved 120 mg flat-fixed dose as a switching option) in virtual adult and pediatric patients with inflammatory bowel disease (IBD). The PBPK model and corresponding simulations were conducted using the PK-Sim® software platform. The PBPK simulation indicated that a 120 mg subcutaneous flat-fixed dose might not be optimal for heavier adults with IBD, suggesting the need for infliximab dose escalation. For an older virtual pediatric patient (14 years old), subcutaneous administration of a 120 mg flat-fixed dose appears to be a feasible IBD treatment option. In the final exploration scenario, the model was extended to predict hypothetical subcutaneous infliximab doses in a virtual pediatric population (6–18 years old), stratified into three weight bands (20–30 kg, 30–45 kg, and 45–70 kg), that would yield post-switch trough concentrations of infliximab comparable to those seen in adults with the 120 mg flat-fixed subcutaneous dose. The PBPK-model-informed dose suggestions were 40 mg for the 20–30 kg band, 80 mg for the 30–45 kg band, and 120 mg for the 45–70 kg band. As demonstrated in this paper, the PBPK modeling framework can serve as a versatile tool in clinical pharmacology to investigate various clinical scenarios, such as exploring alternative dosing regimens and routes of administration, ultimately advancing IBD treatment across diverse (sub)populations of clinical interest. [ABSTRACT FROM AUTHOR]

In recent decades, zebrafish (Danio rerio) has become a widely used vertebrate animal model for studying development and human diseases. However, studies on skin medication using zebrafish are rare. Here, we developed a novel protocol for percutaneous absorption of molecules via the zebrafish tail skin, by applying a liquid solution directly, or using a filter paper imbibed with a chemical solution (coating). Human skin is capable of absorbing felbinac and loxoprofen sodium hydrate (LSH), but not glycyrrhetinic acid (GA) and terbinafine hydrochloride (TH). To evaluate the possibility and the quality of transdermal absorption in zebrafish, we transdermally administered these four drugs to zebrafish. Pharmacokinetics showed that felbinac was present in the blood of zebrafish subjected to all administration methods. Felbinac blood concentrations peaked at 2 h and disappeared 7 h after administration. GA was not detected following transdermal administrations, but was following exposure. LSH was not found in the circulatory system after transdermal administration, but TH was. A dose-response correlation was observed for felbinac blood concentration. These findings suggest that zebrafish are capable of absorbing drug molecules through their skin. However, the present data cannot demonstrate that zebrafish is a practical model to predict human skin absorption. Further systemic studies are needed to observe the correlations in percutaneous absorption between humans and zebrafish. [ABSTRACT FROM AUTHOR]

Purpose: Entrectinib (ENT) is a potent c-ros oncogene 1(ROS1) and neurotrophic tyrosine receptor kinase (NTRKA/B/C) inhibitor. To determine the optimum dosage of ENT using ROS1 and NTRKA/B/C occupancy in plasma and cerebrospinal fluid (CSF) in drug–drug interactions (DDIs), physiologically-based pharmacokinetic (PBPK) models for healthy subjects and cancer population were developed for ENT and M5 (active metabolite). Methods: The PBPK models were built using the modeling parameters of ENT and M5 that were mainly derived from the published paper on the ENT PBPK model, and then validated by the observed pharmacokinetics (PK) in plasma and CSF from healthy subjects and patients. Results: The PBPK model showed that AUC, Cmax, and Ctrough ratios between predictions and observations are within the range of 0.5–2.0, except that the M5 AUC ratio is slightly above 2.0 (2.34). Based on the efficacy (> 75% occupancy for ROS1 and NTRKA/B/C) and safety (AUC < 160 μM·h and Cmax < 8.9 μM), the appropriate dosing regimens were identified. The appropriate dosage is 600 mg once daily (OD) when administered alone, reduced to 200 mg and 400 mg OD with itraconazole and fluconazole, respectively. ENT is not recommended for co-administration with rifampicin or efavirenz, but is permitted with fluvoxamine or dexamethasone. Conclusion: The PBPK models can serve as a powerful approach to predict ENT concentration as well as ROS1 and NTRKA/B/C occupancy in plasma and CSF. [ABSTRACT FROM AUTHOR]

This commentary further reflects on the paper of De Sutter et al. on predicting volume of distribution in neonates, and the performance of physiologically based pharmacokinetic models We hereby stressed the add on value to collaborate on real world data to further close this knowledge gap. We illustrated this by weight distribution characteristics in breastfed (physiology) and in asphyxiated (pathophysiology), with additional reflection on their kidney and liver function. [ABSTRACT FROM AUTHOR]

Taxus, a rare and protected genus predominantly distributed across the Northern Hemisphere's temperate regions, has garnered global attention due to its significant potential in medical research and pharmaceutical development, bolstered by advancements in cultivation techniques and medical technology. This review primarily focuses on the chemical constituents and pharmacological activities of Taxus, underscoring the progress and potential of these components in clinical applications. Recent studies have revealed that Taxus contains not only taxane active components but also flavonoids and polysaccharides with distinct activities. These compounds from Taxus exhibit potent antitumor, anti-inflammatory, immunomodulatory, antibacterial, and antidiabetic properties with evident mechanisms of action. Notably, the representative compound, paclitaxel, has demonstrated significant efficacy in treating various cancers, such as ovarian, breast, and lung cancer. This paper also reviews the basic situation of Taxus drug formulations, with extracts primarily administered orally and monomeric taxanes typically via injection, reflecting a mature development stage with ongoing research into oral formulations. Finally, this review summarizes the pharmacokinetic characteristics of crucial compounds in Taxus, including their absorption, distribution, metabolism, and excretion patterns in the human body. These pharmacokinetic profiles provide crucial guidance for evaluating the overall dosing regimen of Taxus and its components. The paper concludes with a forward-looking analysis of the potential applications of these compounds in disease treatment, envisioning their role in the future of medical and pharmaceutical advancements. [ABSTRACT FROM AUTHOR]

Leonurine is an alkaloid unique to the Leonurus genus, which has many biological activities, such as uterine contraction, anti-inflammation, anti-oxidation, regulation of cell apoptosis, anti-tumor, angiogenesis, anti-platelet aggregation, and inhibition of vasoconstriction. This paper summarizes the extraction methods, synthetic pathways, biosynthetic mechanisms, pharmacokinetic properties, pharmacological effects in various diseases, toxicology, and clinical trials of leonurine. To facilitate a successful transition into clinical application, intensified efforts are required in several key areas: structural modifications of leonurine to optimize its properties, comprehensive pharmacokinetic assessments to understand its behavior within the body, thorough mechanistic studies to elucidate how it works at the molecular level, rigorous safety evaluations and toxicological investigations to ensure patient wellbeing, and meticulously conducted clinical trials to validate its efficacy and safety profile. [ABSTRACT FROM AUTHOR]

This paper presents a thorough examination for drug release from a polymeric matrix to improve understanding of drug release behavior for tissue regeneration. A comprehensive model was developed utilizing mass transfer and machine learning (ML). In the machine learning section, three distinct regression models, namely, Decision Tree Regression (DTR), Passive Aggressive Regression (PAR), and Quadratic Polynomial Regression (QPR) applied to a comprehensive dataset of drug release. The dataset includes r(m) and z(m) inputs, with corresponding concentration of solute in the matrix (C) as response. The primary objective is to assess and compare the predictive performance of these models in finding the correlation between input parameters and chemical concentrations. The hyperparameter optimization process is executed using Sequential Model-Based Optimization (SMBO), ensuring the robustness of the models in handling the complexity of the controlled drug release. The Decision Tree Regression model exhibits outstanding predictive accuracy, with an R2 score of 0.99887, RMSE of 9.0092E-06, MAE of 3.51486E-06, and a Max Error of 6.87000E-05. This exceptional performance underscores the model's capability to discern intricate patterns within the drug release dataset. The Passive Aggressive Regression model, while displaying a slightly lower R2 score of 0.94652, demonstrates commendable predictive capabilities with an RMSE of 6.0438E05, MAE of 4.82782E-05, and a Max Error of 2.36600E-04. The model's effectiveness in capturing non-linear relationships within the dataset is evident. The Quadratic Polynomial Regression model, designed to accommodate quadratic relationships, yields a noteworthy R2 score of 0.95382, along with an RMSE of 5.6655E-05, MAE of 4.49198E-05, and a Max Error of 1.86375E-04. These results affirm the model's proficiency in capturing the inherent complexities of the drug release system. [ABSTRACT FROM AUTHOR]

Modern pharmacological studies have elucidated the presence of aconitine (AC) alkaloids, polysaccharides, and saponins as the primary bioactive constituents of Fuzi. Among these, benzoylaconine, a pivotal active compound, demonstrates notable pharmacological properties including antitumor, anti‐inflammatory, and cardiovascular protective effects. In recent years, benzoylaconine has garnered significant attention in basic research on heart diseases, emerging as a focal point of investigation. This paper presents a comprehensive review of the pharmacological effects of benzoylaconine, alongside an overview of advancements in metabolic characterization. The objective is to furnish valuable insights that can serve as a cornerstone for further exploration, utilization, and advancement of benzoylaconine in pharmacological research. [ABSTRACT FROM AUTHOR]

A novel cholic acid-conjugated carboplatin (CP-CA) is developed as a liver-targeting prodrug of carboplatin (CP) for liver cancer. Instead of using CP as a raw material, CP-CA was synthesized simultaneously. This paper is focused on the comparison of CP-CA and CP with respect to their pharmacokinetic (PK) and tissue distribution profiles in rats after their intravenous administration. Additionally, their uptake by human liver tumor cell Huh7 and normal human liver cell HL7702 are investigated. The inductively coupled plasma mass spectrometry (ICP-MS) method is applied for the determination of platinum in plasma, tissues, and cells. The PK results show that both the AUC0–t and AUC0–∞ data on Pt for CP-CA are significantly higher than those for CP (p < 0.01), indicating that the plasma exposure of CP-CA is significantly higher than that of CP. The CL1, Vd1, and Vd2 data on Pt for CP-CA are significantly lower than those for CP (p < 0.01), while the MRT0–t is significantly higher (p < 0.01), which is possibly related to a higher PPBR, and can strongly support the higher AUC0–t and AUC0–∞ of Pt for CP-CA compared to for CP. The tissue distribution results show that CP-CA is mainly distributed and accumulated in the liver after its intravenous administration to rats, revealing its liver-targeting profile. Compared to CP, CP-CA is more easily taken up by human liver cancer cells and normal human liver cells. The results suggest that CP-CA has a potential for further development as a new prodrug specific to liver cancer. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to study the genetic polymorphisms of related gene loci (CYP2C9*3, VKORC1-1639G > A) based on demographic and clinical factors, and use the maximum a posterior Bayesian method to construct a warfarin individualized dose prediction model in line with the Chinese Han population. Finally, the built model is compared and analyzed with the widely used models at home and abroad. In this study, a total of 5467 INR measurements are collected from 646 eligible subjects in our hospital, and the maximum a posterior Bayesian method is used to construct a warfarin dose prediction that conforms to the Chinese Han population on the basis of the Hamberg model. The model is verified and compared with foreign models. This study finds that body weight and concomitant use of amiodarone have a significant effect on the anticoagulant effect of warfarin. The model can provide an effective basis for individualized and rational dosing of warfarin in Han population more accurately. In the performance of comparison with different warfarin dose prediction models, the new model has the highest prediction accuracy, and the prediction percentage is as high as 72.56%. The dose predicted by the Huang model is the closest to the actual dose of warfarin. The population pharmacokinetics and pharmacodynamics model established in this study can better reflect the distribution characteristics of INR values after warfarin administration in the Han population, and performs better than the models reported in the literature. [ABSTRACT FROM AUTHOR]

Ginseng has a long history of drug application in China, which can treat various diseases and achieve significant efficacy. Ginsenosides have always been deemed important ingredients for pharmacological activities. Based on the structural characteristics of steroidal saponins, ginsenosides are mainly divided into protopanaxadiol‐type saponins (PDS, mainly including Rb1, Rb2, Rd, Rc, Rh2, CK, and PPD) and protopanaxatriol‐type saponins (PTS, mainly including Re, R1, Rg1, Rh1, Rf, and PPT). The structure differences between PDS and PTS result in the differences of pharmacological activities. This paper provides an overview of PDS and PTS, mainly focusing on their chemical profile, pharmacokinetics, hydrolytic metabolism, and pharmacological activities including antioxidant, antifatigue, antiaging, immunodulation, antitumor, cardiovascular protection, neuroprotection, and antidiabetes. It is intended to contribute to an in‐depth study of the relationship between PDS and PTS. [ABSTRACT FROM AUTHOR]

Measurement of pre‐dose tacrolimus concentrations, also referred to as trough concentrations or C0 (in this paper the term C0 will be used), is the most frequently used parameter for therapeutic drug monitoring in patients after solid organ transplantation. C0 is relatively easy to obtain, and can be combined with other lab tests. C0 monitoring is convenient for patient and hospital staff. Adjusting the dose based on C0 assumes that the C0 has a good correlation with the overall exposure to the drug, as reflected in the area under concentration—time curve (AUC).However, C0 may not be the panacea it is suggested to be, and there are patients who may benefit from additional measurements to more precisely assess drug exposure. Especially in patients with a low C0/dose ratio, the peak tacrolimus concentrations after oral administration may be unexpectedly high, resulting in toxicity and (as has been shown already) in poor long‐term graft survival. At the other extreme, patients who only need a very low dose to reach target C0 may have a low peak and also a low AUC and may be underexposed.In this paper, the limitations of C0 will be discussed, and the type of studies needed to provide the evidence for implementation of more sophisticated therapeutic drug monitoring. The paper focuses on treatment of adult kidney transplant recipients. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to investigate the anti-inflammatory and anti-angiogenic activities of sulfated polysaccharide from C. tomentosum (PCT) using carrageenan (CARR)-induced paw edema in a rat model and anti-vasculogenic activity on a chorioallantoic membrane assay (CAM) model. Based on in vitro tests of anti-radical, total antioxidant, and reducing power activities, PCT presents a real interest via its antioxidant activity and ability to scavenge radical species. The in vivo pharmacological tests suggest that PCT possesses anti-inflammatory action by reducing paw edema and leukocyte migration, maintaining the redox equilibrium, and stabilizing the cellular level of several pro-/antioxidant system markers. It could significantly decrease the malondialdehyde levels and increase superoxide dismutase, glutathione peroxidase, and glutathione activities in local paw edema and erythrocytes during the acute inflammatory reaction of CARR. PCT pretreatment was effective against DNA alterations in the blood lymphocytes of inflamed rats and reduced the hematological alteration by restoring blood parameters to normal levels. The anti-angiogenic activity results revealed that CAM neovascularization, defined as the formation of new vessel numbers and branching patterns, was decreased by PCT in a dose-dependent manner, which supported the in silico bioavailability and pharmacokinetic findings. These results indicated the therapeutic effects of polysaccharides from C. tomentosum and their possible use as anti-proliferative molecules based on their antioxidant, anti-inflammatory, and anti-angiogenic activities. [ABSTRACT FROM AUTHOR]

In the past decade, only a small number of papers have elaborated on the application of physiologically based pharmacokinetic (PBPK) modeling across different areas. In this review, an in-depth analysis of the distribution of PBPK modeling in relation to its application in various research topics and model validation was conducted by text mining tools. Orange 3.32.0, an open-source data mining program was used for text mining. PubMed was used for data retrieval, and the collected articles were analyzed by several widgets. A total of 2699 articles related to PBPK modeling met the predefined criteria. The number of publications per year has been rising steadily. Regarding the application areas, the results revealed that 26% of the publications described the use of PBPK modeling in early drug development, risk assessment and toxicity assessment, followed by absorption/formulation modeling (25%), prediction of drug-disease interactions (20%), drug-drug interactions (DDIs) (17%) and pediatric drug development (12%). Furthermore, the analysis showed that only 12% of the publications mentioned model validation, of which 51% referred to literature-based validation and 26% to experimentally validated models. The obtained results present a valuable review of the state-of-the-art regarding PBPK modeling applications in drug discovery and development and related fields. [ABSTRACT FROM AUTHOR]

Pharmacometric modelling plays a key role in both the design and analysis of regulatory trials in paediatric drug development. Studies in adults provide a rich source of data to inform the paediatric investigation plans, including knowledge on drug pharmacokinetics (PK), safety and efficacy. In children, drug disposition differs widely from birth to adolescence but extrapolating adult to paediatric PK, safety and efficacy either with pharmacometric or physiologically based approaches can help design or in some cases reduce the need for clinical studies. Aspects to consider when extrapolating PK include the maturation of drug metabolizing enzyme expression, glomerular filtration, drug excretory systems, and the expression and activity of specific transporters in conjunction with other drug properties such as fraction unbound. Knowledge of these can be used to develop extrapolation tools such as allometric scaling plus maturation functions or physiologically based PK. PK/pharmacodynamic approaches and well‐designed clinical trials in children are of key importance in paediatric drug development. In this white paper, state‐of‐the‐art of current methods used for paediatric extrapolation will be discussed. This paper is part of a conect4children implementation of innovative methodologies including pharmacometric and physiologically based PK modelling in clinical trial design/paediatric drug development through dissemination of expertise and expert advice. The suggestions arising from this white paper should define a minimum set of standards in paediatric modelling and contribute to the regulatory science. [ABSTRACT FROM AUTHOR]

Naturally derived alkaloids belong to a class of quite significant organic compounds. Coptisine, a benzyl tetrahydroisoquinoline alkaloid, is one of the major bioactive constituents in Coptis chinensis Franch., which is a famous traditional Chinese medicine. C. chinensis possesses many kinds of functions, including the ability to eliminate heat, expel dampness, purge fire, and remove noxious substances. In Asian countries, C. chinensis is traditionally employed to treat carbuncle and furuncle, diabetes, jaundice, stomach and intestinal disorders, red eyes, toothache, and skin disorders. Up to now, there has been plenty of research of coptisine with respect to its pharmacology. Nevertheless, a comprehensive review of coptisine-associated research is urgently needed. This paper was designed to summarize in detail the progress in the research of the pharmacology, pharmacokinetics, safety, and formulation of coptisine. The related studies included in this paper were retrieved from the following academic databases: The Web of Science, PubMed, Google scholar, Elsevier, and CNKI. The cutoff date was January 2023. Coptisine manifests various pharmacological actions, including anticancer, antimetabolic disease, anti-inflammatory disease, and antigastrointestinal disease effects, among others. Based on its pharmacokinetics, the primary metabolic site of coptisine is the liver. Coptisine is poorly absorbed in the gastrointestinal system, and most of it is expelled in the form of its prototype through feces. Regarding safety, coptisine displayed potential hepatotoxicity. Some novel formulations, including the β -cyclodextrin-based inclusion complex and nanocarriers, could effectively enhance the bioavailability of coptisine. The traditional use of C. chinensis is closely connected with the pharmacological actions of coptisine. Although there are some disadvantages, including poor solubility, low bioavailability, and possible hepatotoxicity, coptisine is still a prospective naturally derived drug candidate, especially in the treatment of tumors as well as metabolic and inflammatory diseases. Further investigation of coptisine is necessary to facilitate the application of coptisine-based drugs in clinical practice. [ABSTRACT FROM AUTHOR]