Novel strategy to personalise use of ibuprofen for closure of patent ductus arteriosus in preterm neonates.
Arch Dis Child
; 107(1): 86-91, 2022 01.
Article
em En
| MEDLINE
| ID: mdl-33975823
ABSTRACT
OBJECTIVE:
Exploration of a novel therapeutic drug monitoring (TDM) strategy to personalise use of ibuprofen for closure of patent ductus arteriosus (PDA) in preterm neonates.DESIGN:
Prospective, single-centre, open-label, pharmacokinetics study in preterm neonates.SETTING:
Neonatal intensive care unit at McMaster Children's Hospital. PATIENTS Neonates with a gestational age ≤28+6 weeks treated with oral ibuprofen for closure of a PDA.METHODS:
Population pharmacokinetic parameters, concentration-time profiles and exposure metrics were obtained using pharmacometric modelling and simulation. MAIN OUTCOMEMEASURE:
Association between ibuprofen plasma concentrations measured at various sampling time points on the first day of treatment and attainment of the target exposure over the first 3 days of treatment (AUC0-72h >900 mg·hour/L).RESULTS:
Twenty-three preterm neonates (median birth weight 780 g and gestational age 25.9 weeks) were included, yielding 155 plasma ibuprofen plasma samples. Starting from 8 hours' postdose on the first day, a strong correlation between ibuprofen concentrations and AUC0-72h was observed. At 8 hours after the first dose, an ibuprofen concentration >20.5 mg/L was associated with a 90% probability of reaching the target exposure.CONCLUSION:
We designed a novel and practical TDM strategy and have shown that the chance of reaching the target exposure (AUC0-72h >900 mg·hour/L) can be predicted with a single sample collection on the first day of treatment. This newly acquired knowledge can be leveraged to personalise ibuprofen dosing regimens and improve the efficacy of ibuprofen use for pharmacological closure of a PDA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Anti-Inflamatórios não Esteroides
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Ibuprofeno
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Permeabilidade do Canal Arterial
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Doenças do Prematuro
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
/
Newborn
Idioma:
En
Revista:
Arch Dis Child
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Canadá