Re: Re: Weight based dosing

From: Michael Fossler Date: December 09, 2015 technical Source: mail-archive.com
While it is important to look at the variability explained by the covariate, your question is not really a statistical one. You need to evaluate the clinical significance of the change in exposure by weight. For a given dose, how does exposure change by weight and how will this affect the efficacy of the antibiotic under various assumptions of bacterial sensitivity? Think about how you can use your model to answer the clinical question - you won't find the answer in p-values or objective function changes. Mike Fossler
Quoted reply history
On Dec 8, 2015, at 9:28 PM, Sultan,Abdullah S <[email protected]<mailto:[email protected]>> wrote: Hi Rudy Gunawan, Thanks for the helpful information, I tried both methods, fixing the exponents at 0.75 and 1 and estimating them, results for both models are similar, No other covariate (demographic variables or lab test) showed any correlation with Cl/F. my main question is how important is it to look at the variability explained by a covariate? And can it be used to determine if a covrariate is not clinically significant Thanks, Abdullah Sultan ________________________________ From: Rudy Gunawan <[email protected]<mailto:[email protected]>> Sent: Tuesday, December 8, 2015 8:10 PM To: Sultan,Abdullah S; [email protected]<mailto:[email protected]> Subject: RE: Weight based dosing Hi Abdullah Sultan, Since your estimate is not too far from 0.75 exponent in Clearances, did you try using the theoretical allometric scaling (0.75 in all clearances and 1.00 in volumes)? With these, it would be easier to justify. Once you include the body size, I would suggest you check the matrix plots of ETA in CL or V versus other covariates (demo, labs, etc) to see if there is any other info would help explain the variability. Without knowing more of the nature of the drug, I think these would help build the model. Hope this helps, Rudy From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Sultan,Abdullah S Sent: Tuesday, December 08, 2015 4:40 PM To: [email protected]<mailto:[email protected]> Subject: [NMusers] Weight based dosing Hi everyone, I am developing a POP PK model for an anti-infective drug, I am trying to determine if dosing should be weight based or not. The range of weight in the study was 40-100 kg. Weight was statistically significant for Cl/F but only explained 9% of the variability observed for Cl. I used allometric scaling to describe weights effect on Cl/F and slope effect of weight was 0.58, and scaled to 60 kg (the median). Based on the slope effect estimated, AUC is predicted to decrease by 15% for an 80 kg individual, and increase by 25% for an individual that weights 40 kg compared to a 60 kg individual. How much should I trust the slope effect determined by my study? and should I rely on it to develop the dosing regimen? if weight only explained 9% of variability observed with Cl/F, could that indicate that it is not clinically significant and weight based dosing is not required? Thanks, Abdullah Sultan, PhD candidate University of Florida ________________________________ Notice: This e-mail message, together with any attachments, contains information of Trevena, Inc., 1018 West 8th Avenue, King of Prussia, PA 19406, USA. This information may be confidential, proprietary, copyrighted and/or legally privileged. It is intended solely for use by the individual or entity named on this message. If you are not the intended recipient, and have received this message in error, please notify us immediately and delete it and any attachments from your system.
Dec 09, 2015 Abdullah S Sultan Weight based dosing
Dec 09, 2015 Rudy Gunawan RE: Weight based dosing
Dec 09, 2015 Ahmad Abu Helwa RE: Weight based dosing
Dec 09, 2015 Stefanie Hennig RE: Weight based dosing
Dec 09, 2015 Michael Fossler Re: Re: Weight based dosing
Dec 09, 2015 Nick Holford Re: RE: Weight based dosing