创新链/学科链/研发链/产业链

新药研发前沿动态 / 医药领域趋势进展

基于最大后验贝叶斯法的个体化用药研究进展

Advance of Research on Individualized Dosing Based on Maximum a Posteriori Bayesian Method

  • 摘要: 最大后验贝叶斯法(MAPB)在个体化给药中的作用日益受到重视。该法通过已知的目标人群的群体药动学(PPK)特征,结合治疗药物监测(TDM)结果,可准确地估算患者个体药动学(PK)参数,进而基于药动学/药效学(PK/PD)原理进行个体化给药方案的制定。MAPB法广泛用于抗感染药物、免疫抑制剂、抗凝药、抗肿瘤药等领域,可显著提高患者达到目标治疗窗的比例、降低药物不良反应的发生率、缩短住院时间、改善临床结局等。国内外已开发了基于MAPB法的临床决策辅助系统,协助医务工作者实现给药个体化。阐述MAPB法的基本原理、实施流程及在不同治疗领域中的应用,并对基于MAPB法的常用临床决策辅助系统作一简介,以期为进一步研究和指导个体化用药提供参考。

     

    Abstract: Maximum a posteriori Bayesian (MAPB) method has attracted more and more attention in individualized dosing. Through a combination of prior population pharmacokinetics (PPK) characteristics of the target population and the results of therapeutic drug monitoring (TDM), the individual PK parameters of patients can be accurately estimated, and thus the individualized pharmacotherapeutic strategies based on PK/PD principle can be formulated. MAPB is used to optimize dose individualization of various therapeutic areas such as anti-infective drugs, immunosuppressants, anticoagulants, and antineoplastics, helping to increase the proportion of patients reaching the target therapeutic window, avoid adverse drug reactions, shorten length of hospital stay and improve clinical outcomes. So far, several MAPB-based clinical decision support systems have been developed to guide individualized dosing. This review aims to present the concepts of MAPB, clarify its process, illustrate its application in individualized dosing in various therapeutic areas, and introduce some MAPB-based clinical decision support systems, in an attempt to provide reference for further research and dose individualization.

     

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