儿科药学杂志2025，Vol.31Issue(3)：1-5,5.DOI:10.13407/j.cnki.jpp.1672-108X.2025.03.001
应用蒙特卡罗模拟评价和优化第三代抗癫痫药物拉考沙胺的儿童给药方案
Application of Monte Carlo Simulation to Evaluate and Optimize the Pediatric Dosage Regimen of the Third-Generation Antiepileptic Drug Lacosamide
万雄飞 1廖念 1朱珊珊 1汪洋 2梁美锋1
作者信息
- 1. 武汉科技大学附属华润武钢总医院,武汉 430080
- 2. 华中科技大学同济医学院附属武汉儿童医院,武汉 430016
- 折叠
摘要
Abstract
Objective:To evaluate and optimize the dosage regimen of lacosamide(LCM)for the treatment of epilepsy in children,and promote individualized medication.Methods:Based on the published pharmacokinetic/pharmacodynamic(PK/PD)parameters of LCM in children with epilepsy,Monte Carlo simulation(MCS)was used to calculate the steady-state trough plasma concentration(Co)after oral administration of different doses of LCM in patients stratified by body weight and co-medication characteristics.The rationality of different LCM maintenance dose regimens was evaluated based on the probability of target concentration(PTA)of C0 relative to the target range of 2 to 7 mg/L.And simulation tests were employed to assess the off-target situation of LCM trough concentration in children with epilepsy under different scenarios of missed doses and to establish appropriate remedial regimens.Results:The probability of achieving the lower limit of the target concentration range for C0 in children with epilepsy after administration of LCM maintenance dose regimens and remedial dose regimens recommended in this study was ≥ 75％,and the probability of exceeding the upper limit was low.Simulation results showed that in order to achieve the same level of in vivo drug exposure,children with low body weight should be given a higher weight correction dose,and the dose of LCM in combination with enzyme inducers should be increased to 1.5 to 2.3 times that of monotherapy.Conclusion:In this study,MCS is used to optimize the maintenance dose regimens for stratified children with different body weight and co-medication characteristics,and to establish the remedial dose regimens after missing medication,which can provide reference for clinical individualized medication of LCM.关键词
蒙特卡罗模拟/拉考沙胺/儿童/癫痫/个体化用药Key words
Monte Carlo simulation/lacosamide/children/epilepsy/individualized medication分类
药学引用本文复制引用
万雄飞,廖念,朱珊珊,汪洋,梁美锋..应用蒙特卡罗模拟评价和优化第三代抗癫痫药物拉考沙胺的儿童给药方案[J].儿科药学杂志,2025,31(3):1-5,5.
