王晓文, 何庆烽, 相小强, 韩冰. 生理药代动力学模型预测抑酸药物所致药物相互作用的研究进展J. 药学学报, 2021,56(8): 2197-2203. doi: 10.16438/j.0513-4870.2021-0272
引用本文: 王晓文, 何庆烽, 相小强, 韩冰. 生理药代动力学模型预测抑酸药物所致药物相互作用的研究进展J. 药学学报, 2021,56(8): 2197-2203. doi: 10.16438/j.0513-4870.2021-0272
WANG Xiao-wen, HE Qing-feng, XIANG Xiao-qiang, HAN Bing. Physiologically-based pharmacokinetic modeling for predicting drug-drug interactions induced by acid-reducing agentsJ. Acta Pharmaceutica Sinica, 2021,56(8): 2197-2203. doi: 10.16438/j.0513-4870.2021-0272
Citation: WANG Xiao-wen, HE Qing-feng, XIANG Xiao-qiang, HAN Bing. Physiologically-based pharmacokinetic modeling for predicting drug-drug interactions induced by acid-reducing agentsJ. Acta Pharmaceutica Sinica, 2021,56(8): 2197-2203. doi: 10.16438/j.0513-4870.2021-0272

生理药代动力学模型预测抑酸药物所致药物相互作用的研究进展

Physiologically-based pharmacokinetic modeling for predicting drug-drug interactions induced by acid-reducing agents

  • 摘要: 胃内pH是影响药物吸收的重要生理因素,尤其对于弱碱性药物,胃内pH的升高可能引起生物利用度下降。质子泵抑制剂、H2受体阻滞剂、抗酸剂等抑酸药(acid-reducing agents,ARAs)可升高胃内pH,产生药物相互作用(drug-drug interactions,DDIs),影响疗效。生理药代动力学(physiologically based pharmacokinetics,PBPK)模型是研究口服药物相互作用的重要工具,常用的有高级房室吸收和转运(advanced compartmental absorption and transit,ACAT)模型和高级溶出吸收和代谢(advanced dissolution,absorption and metabolism,ADAM)模型。在PBPK模拟软件中输入相关参数,建立基础模型后,通过调整模型参数模拟胃内pH的变化,预测对药物吸收的影响,可用于临床上给药方案的调整和新药研发过程中的候选药物筛选。本综述简述了PBPK模型用于预测药物吸收的理论基础及常用模型,总结了不同ARA类药物对胃内pH的影响,并列举了目前PBPK模型在预测胃内pH对药物吸收影响的一些应用实例。

     

    Abstract: Gastric pH is an important factor that affects drug absorption, as gastric pH may lead to lower bioavailability, especially for weak-base drugs. Acid-reducing agents (ARAs) such as antacids, histamine-2 receptor antagonists, and proton pump inhibitors, are susceptible to drug-drug interactions (DDIs), potentially resulting in the loss of efficacy. Physiologically based pharmacokinetic (PBPK) modeling is an important tool for the evaluation of oral drug-drug interactions and the most commonly used models include the advanced comparative absorption and transport (ACAT) model and the advanced dissolution, absorption and metabolism (ADAM) model. These models can be used for adjustment of the dosage regimen and the screening of candidate drugs in drug development by simulating the change of gastric pH to predict the change in drug absorption. This review summarizes the theoretical basis, the most common PBPK models used to predict drug absorption, and the effects of different kinds of ARAs drugs on gastric pH. Some successful applications of PBPK modeling in predicting the effects of gastric pH on drug absorption are also presented.

     

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