RE: Assessment of elimination half life of mAb
Hi Leonid,
First of all thanks for your response saying half-life has no useful meaning
for a drug with non-linear PK (clearance and/or volume, plasma protein binding,
etc).
Half-life is a useful parameter for some simple cases but when the question
about the time course of drug effect then half-life has little value. Add in
non-linear PK to the non-linear PD and then delayed concentration-effect makes
it even harder.
A simulation (a picture is worth a thousand words) can show the complexity and
also give a 'feeling' for the answer to the question. Pseudo-solutions like the
'context sensitive half-life' should be avoided because half-life only has a
scientifically useful meaning for first-order processes that can be visualised
as exponential curves.
Life is more than PK -- its PKPD is when it gets interesting (and complicated).
Best wishes,
Nick
--
Nick Holford, Professor Clinical Pharmacology
Dept Pharmacology & Clinical Pharmacology, Bldg 503 Room 302A
University of Auckland,85 Park Rd,Private Bag 92019,Auckland,New Zealand
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Quoted reply history
-----Original Message-----
From: [email protected] <[email protected]> On Behalf Of
Leonid Gibiansky
Sent: Thursday, 29 April 2021 6:42 PM
To: Justin Wilkins <[email protected]>; Bill Denney
<[email protected]>; Bonate, Peter <[email protected]>;
Niurys.CS <[email protected]>
Cc: [email protected]
Subject: Re: [NMusers] Assessment of elimination half life of mAb
still, half-life of the linear part could be helpful in cases when
non-linearity plays no significant role in elimination, so we tend to present
it together with the washout time simulations.
Leonid
On 4/29/2021 12:35 PM, Justin Wilkins wrote:
> Hi Bill, all,
>
> I do much the same thing - when there's nonlinearity happening, I've found it
> to be effective to plot concentration-time curves by doses and regimens of
> interest and mark the times at which the (median?) clinically-defined
> threshold for "washout" has been reached in each case. Of course this starts
> getting unwieldy when there are lots of doses or regimens. A less attractive
> way would be to produce a lookup table.
>
> Sounds like everyone's thinking along the same lines...
>
> Justin
>
>
> -----Original Message-----
> From: [email protected] <[email protected]> On
> Behalf Of Bill Denney
> Sent: Thursday, April 29, 2021 6:17 PM
> To: Bonate, Peter <[email protected]>; Leonid Gibiansky
> <[email protected]>; Niurys.CS <[email protected]>
> Cc: [email protected]
> Subject: RE: [NMusers] Assessment of elimination half life of mAb
>
> Hi Pete,
>
> I agree that it is hard to communicate. I like the general idea of C90 you
> propose. I tend to choose something in between your and Leonid's answer,
> when possible. I target an answer of "when is the pharmacodynamic effect <5%
> of the maximum or therapeutic effect". It does require more than just the
> PK, though. And for the just PK answer, I agree with Leonid and you,
> targeting some smallish fraction of Cmax is often reasonable for similar
> communication.
>
> What I find clinicians typically try to understand when the drug has washed
> out. The answer that many have reasonably latched onto is when 5 half-lives
> have passed, the drug is washed out. That suggests that about 3% (2^-5)
> effect is generally agreed as being washed out.
>
> To Niurys's question about a citation for this, I don't have one either.
> It's just a rule-of-thumb that I have tended to use.
>
> Thanks,
>
> Bill
>
> -----Original Message-----
> From: [email protected] <[email protected]> On
> Behalf Of Bonate, Peter
> Sent: Thursday, April 29, 2021 12:01 PM
> To: Leonid Gibiansky <[email protected]>; Niurys.CS
> <[email protected]>
> Cc: [email protected]
> Subject: RE: [NMusers] Assessment of elimination half life of mAb
>
> I've never really been happy with this. It's an unsatisfactory solution.
> You have a nonlinear drug. Let's assume you have an approved drug. It's
> given at some fixed dose. The clinician wants to know what is the drug's
> half-life so they can washout their patient and start them on some other
> therapy. We go back to them and say, we can't give you a half-life because
> it's a nonlinear drug, but once the kinetics become linear the half-life is X
> hours. That is a terrible answer. Maybe we need to come up with a new term,
> call it C90, the time it takes for Cmax to decline by 90%. That we can do.
> We don't even need an analytical solution, we can eyeball it. We could even
> get fancy and do it in a population model. C90 - the time it takes for Cmax
> to decline 90% in 90% of patients. Of course, for nonlinear drugs, C90 only
> holds for that dose. Change in dose results in a new C90.
> Just a thought.
>
> pete
>
>
>
> Peter Bonate, PhD
> Executive Director
> Pharmacokinetics, Modeling, and Simulation (PKMS) Clinical
> Pharmacology and Exploratory Development (CPED) Astellas
> 1 Astellas Way, N3.158
> Northbrook, IL 60062
> [email protected]
> (224) 619-4901
>
>
> It’s been a while since I’ve had something here, but here is a Dad joke.
>
> Question: Do you know why the math book was sad?
> Answer: Because it had so many problems
>
>
> -----Original Message-----
> From: [email protected] <[email protected]> On
> Behalf Of Leonid Gibiansky
> Sent: Thursday, April 29, 2021 9:54 AM
> To: Niurys.CS <[email protected]>
> Cc: [email protected]
> Subject: Re: [NMusers] Assessment of elimination half life of mAb
>
> I am not aware of any papers specifically addressing the half-live
> issue, but there are tons of original papers and tutorials on TMDD,
> just search the web Thanks Leonid
>
> On 4/29/2021 9:48 AM, Niurys.CS wrote:
>> Dear Leonid,
>>
>> Many thanks for clearing up my doubt. Can you suggest me any paper to
>> go into this topic in any depth.
>> Best,
>> Niurys
>>
>> El 28/04/2021 19:34, "Leonid Gibiansky" <[email protected]
>> <mailto:[email protected]>> escribió:
>>
>> There is no such thing as half-life of elimination for the nonlinear
>> drug. But one can compute something like half-life:
>>
>> 1. Half-life of the linear part (defined by CL, V1, V2, Q): this
>> defines the half-life at high doses/high concentrations when
>> nonlinear elimination is saturated.
>>
>> 2. Washout time: for the linear drug, 5 half-lives can be used to
>> define washout time. During this time, concentrations drop
>> approximately 2^5=32 times. So one can simulate the desired dosing
>> (single dose or steady state), find the time from Cmax to Cmax/32
>> and call it washout time (or time to Cmax/64 to be conservative)
>>
>> Thanks
>> Leonid
>>
>>
>> On 4/28/2021 5:17 PM, Niurys.CS wrote:
>>
>> Dear all
>> I need some help to assess the elimination half life of a
>> monoclonal antibody.
>> The model that describes the data is a QSS aproximation of TMDD
>> with Rmax constant. The model includes two binding process of
>> mAb to its target: in central and peripheral compartments.
>> Is there any specific equation to calcule lambda z and the
>> elimination half life for each of the TMDD aproximations?
>> Thanks
>> Niurys
>>
>