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I am interested in anyone who is using PK/PD models in the clinical setting to optimize dosing..
1. Which drugs?
2. What software (or ‘homegrown’ application) are you using?
Thanks in advance…
Brady S Moffett, PharmD, MPH
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Brady,
Our lab has been focused on this task for over 40 years. We call our dosing software "BestDose".
It is freely available to research collaborators. You can contact me or via our website
www.lapk.org. BestDose is immediately usable as an R application (minimal R required) but we are
working on a web-based user interface, which can be run from any browser, including a tablet.
Here's a list of published clinical use papers with BestDose or its precursor "MM-USCPACK".
Hope, W. W. et al. Software for dosage individualization of voriconazole for immunocompromised
patients. Antimicrob Agents Chemother 57, 1888–1894 (2013).
Neely, M. et al. Achieving target voriconazole concentrations more accurately in children and
adolescents. Antimicrob Agents Chemother AAC.00032–15 (2015). doi:10.1128/AAC.00032-15
Felton, T. W. et al. Individualization of Piperacillin Dosing for Critically Ill Patients: Dosing
Software To Optimize Antimicrobial Therapy. Antimicrob Agents Chemother 58, 4094–4102 (2014).
Nunn, M. O. et al. Vancomycin dosing: assessment of time to therapeutic concentration and predictive
accuracy of pharmacokinetic modeling software. The Annals of Pharmacotherapy 45, 757–763 (2011).
Størset, E. et al. Improved Tacrolimus Target Concentration Achievement Using Computerized Dosing in
Renal Transplant Recipients-A Prospective, Randomized Study. Transplantation 1 (2015).
doi:10.1097/TP.0000000000000708
Neely, M. & Jelliffe, R. Practical therapeutic drug management in HIV-infected patients: use of
population pharmacokinetic models supplemented by individualized Bayesian dose optimization. 48,
1081–1091 (2008).
Also, there are several ongoing projects (our own and with collaborators) in various stages, which
have not yet been published:
Busulfan in children
Beta-lactams in critically ill adults
Vancomycin in adults
Tacrolimus in adults
Valganciclovir in children
Factor replacement in hemophilia
Cefepime in critically ill children
Tobramycin in adults with CF
Lastly, there is an older, stand-alone Windows application with models for vancomycin,
aminoglycosides, and digoxin.
Hope that helps.
--
Michael Neely, MD, MSc, FCP
Director, Laboratory of Applied Pharmacokinetics and Bioinformatics
The Saban Research Institute,
Children's Hospital Los Angeles
Associate Professor and Clinical Scholar,
Division of Infectious Diseases,
Department of Pediatrics, Keck School of Medicine,
University of Southern California
4650 Sunset. Blvd, #MS 30
Los Angeles, CA 90027
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Dr. Moffett,
UCSD uses a program called TDMS.
http://www.tdms2000.com
Joseph Chen
2016 Pharm. D. Candidate
UCSD SSPPS
UCSD PILL Co-President
Kappa Psi Pharmaceutical Fraternity Inc.
jjc018.-a-.ucsd.edu
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Dear Brady:
We at the USC Laboratory for Applied Pharmacokinetics have had software for dosage
individualization since 1967. This has now evolved into the USC Bestdose clinical software. You
might go to www.lapk.org and click around. You will find software, and many things to read. Please
let me know if you have more questions. Our software is unique in that it develops dosage regimens
which are specifically designed to hit desired therapeutic target goals with maximum precision (
minimum weighted squared error). It also has an option to use an interacting multiple model approach
which permits model parameter values to change as each new dose is given or serum concentration is
obtained. These are specifically designed for very unstable patients, who are often on dialysis or
renal replacement therapy.
Very best regards,
Roger Jelliffe
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Hi Brady,
Our research group (Otago Pharmacometrics) has a strong focus in this area. We have three faculty
members (myself, Steve Duffull, and Hesham Al-Sallami) who are all interested in the translation of
PKPD to clinical practice. The ultimate aim is to improve patient outcomes through dose
optimisation. A particular focus of late is the development, identifiability, and simplification of
systems biology models with the goal of translating outputs from these complex models to the
clinical setting.
Drugs;
Anticoagulants,
Antimalarials,
Aminoglycosides,
Allopurinol and other urate-lowering drugs
Methotrexate,
Metformin,
Azathioprine,
Carboplatin, oxaliplatin
Software;
Steve has used several platforms over the years - mostly developed in-house or with colleagues. My
work has primarily used TCIWorks.
Kind regards,
Dan Wright
http://www.pharmacometrics.co.nz/
Dan Wright PhD
Otago Pharmacometrics Group
School of Pharmacy, University of Otago
PO Box 56, Dunedin , New Zealand
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