The AAPS Journal

, Volume 15, Issue 4, pp 1012–1024

A Simplified PBPK Modeling Approach for Prediction of Pharmacokinetics of Four Primarily Renally Excreted and CYP3A Metabolized Compounds During Pregnancy

  • Binfeng Xia
  • Tycho Heimbach
  • Rakesh Gollen
  • Charvi Nanavati
  • Handan He
Research Article

Abstract

During pregnancy, a drug’s pharmacokinetics may be altered and hence anticipation of potential systemic exposure changes is highly desirable. Physiologically based pharmacokinetics (PBPK) models have recently been used to influence clinical trial design or to facilitate regulatory interactions. Ideally, whole-body PBPK models can be used to predict a drug’s systemic exposure in pregnant women based on major physiological changes which can impact drug clearance (i.e., in the kidney and liver) and distribution (i.e., adipose and fetoplacental unit). We described a simple and readily implementable multitissue/organ whole-body PBPK model with key pregnancy-related physiological parameters to characterize the PK of reference drugs (metformin, digoxin, midazolam, and emtricitabine) in pregnant women compared with the PK in nonpregnant or postpartum (PP) women. Physiological data related to changes in maternal body weight, tissue volume, cardiac output, renal function, blood flows, and cytochrome P450 activity were collected from the literature and incorporated into the structural PBPK model that describes HV or PP women PK data. Subsequently, the changes in exposure (area under the curve (AUC) and maximum concentration (Cmax)) in pregnant women were simulated. Model-simulated PK profiles were overall in agreement with observed data. The prediction fold error for Cmax and AUC ratio (pregnant vs. nonpregnant) was less than 1.3-fold, indicating that the pregnant PBPK model is useful. The utilization of this simplified model in drug development may aid in designing clinical studies to identify potential exposure changes in pregnant women a priori for compounds which are mainly eliminated renally or metabolized by CYP3A4.

Key words

PBPK models pharmacokinetics physiological changes pregnancy systemic exposure 

Supplementary material

12248_2013_9505_MOESM1_ESM.docx (465 kb)
ESM 1DOCX 464 kb

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Copyright information

© American Association of Pharmaceutical Scientists 2013

Authors and Affiliations

  • Binfeng Xia
    • 1
  • Tycho Heimbach
    • 1
  • Rakesh Gollen
    • 2
  • Charvi Nanavati
    • 3
  • Handan He
    • 1
  1. 1.Novartis Institutes for Biomedical ResearchDMPK–Translational SciencesEast HanoverUSA
  2. 2.Division of Pharmaceutical Sciences, Pharmacy and Health SciencesLong Island UniversityBrooklynUSA
  3. 3.Department of Pharmaceutical Sciences, University at BuffaloState University of New YorkBuffaloUSA

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