Abstract
The pharmacokinetic–pharmacodynamic (PK–PD) relationship of the granulopoietic effects of Filgrastim in healthy volunteers was characterized via a population approach. Healthy male volunteers were enrolled into a four-way crossover clinical trial. Subjects received four single doses of Filgrastim (375 and 750 μg iv and sc) with an intervening washout period of 7 days. Serum concentrations of Filgrastim were determined using an enzyme-linked immunosorbent assay. Absolute neutrophil count (ANC) was determined. Data analysis was performed using mixed-effects modeling as implemented in the NONMEM software package. The final PKPD model incorporates a two-compartment PK model with bisegmental absorption from the sc site, first-order and saturable elimination pathways, and an indirect PD model. A sigmoidal Emax model for the stimulation of ANC input rate kin) was superior to the conventional Emax model (\({\bar X}\) ±SE: Emax=12.7 ± 1.7; EC50=4.72 ± 0.72 ng/ml; Hill=1.34 ± 0.19). In addition, a time-variant scaling factor for ANC observations was introduced to account for the early transient depression of ANC after Filgrastim administration. The absolute bioavailability of subcutaneously administered Filgrastim was estimated to be 0.619±0.058 and 0.717±0.028 for 375 μg and 750 μg sc doses, respectively. The time profiles of concentration and ANC, as well as the concentration∼ANC relationship of Filgrastim in healthy volunteers were well described by the developed population PK–PD model.
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REFERENCES
K. Welte, J. Gabrilove, M. H. Bronchud, E. Platzer, and G. Morstyn. Filgrastim (rmetHuG-CSF): The first 10 years. Blood 88: 1907–1929 (1996).
S. Kojima, M. Fukuda, Y. Miyajima, T. Matsuyama, and K. Horibe. Treatment of aplastic anemia in children with recombinant human granulocyte colony-stimulating factor. Blood 77:937–941 (1991).
G. S. Chatta, T. H. Price, R. C. Allen, and D. C. Dale. Effects of in vivo recombinant methionyl human granulocyte colony-stimulating factor on the neutrophil response and peripheral blood colony-forming cells in healthy young and elderly adult volunteers. Blood 84:2923–2929 (1994).
U. Duhrsen, J. L. Villeval, J. Boyd, G. Kannourakis, G. Morstyn, and D. Metcalf. Effects of recombinant human granulocyte colony-stimulating factor on hematopoietic progenitor cells in cancer patients. Blood 72: 2074–2081 (1988).
W. Sheridan. Cytokine only approaches to mobilization of progenitor cells. In G. Morstyn and W. Sheridan (eds.), Cell Therapy: Stem Cell Transplantation, Gene Therapy, and Cellular Immunotherapy, Cambridge University Press, Cambridge, 1996.
Guidelines for bioavailability and bioequivalence studies, Drug Evaluation Branch, Therapeutic Goods Administration, Australia, December 1989.
Amgen. A Phase I, Double-blind, randomized, crossover study comparing the pharmacokinetics and pharmacodynamics of sorbitol and mannitola formulations of filgrastim in normal healthy volunteers, Clinical Study Report, Amgen Inc.
J. Liu and S. Chow. Sample size determination for the two one-sided tests procedure in bioequivalence. J. Pharmacokin. Biopharm. 20: 101 (1992).
S. L. Beal and L. B. Sheiner. NONMEM Users Guide, NONMEM Project Group, University of California, San Francisco, 1992.
J. L. Gabrilove, A. Jakubowski, K. Fain, J. Grous, H. Scher, C. Sternberg, A. Yagoda, and B. Clarkson. Phase I study of granulocyte colony-stimulating factor in patients with transitional cell carcinoma of the urothelium. J. Clin. Invest. 82: 1454–1461 (1988).
N. L. Dayneka, V. Garg, and W. J. Jusko. Comparison of four basic models of indirect pharmacodynamic responses. J. Pharmacokin. Biopharm. 21: 457–478 (1993).
L. K. Roskos, E. N. Cheung, M. Vincent, M. Foote, and G. Morstyn. Pharmacology of Filgrastim (r-meHuG-CSF). In G. Morstyn, T. M. Dexter, and M. Foote (eds.), Filgrastim (r-meHuG-CSF) in Clinical Practice, 2nd Ed., Marcel Dekker, New York, 1998.
B. Wang, T. M. Ludden, E. N. Cheung, S. Cruickshank, G. Schwab, and L. K. Roskos. Determination of absolute bioavailability of subcutaneously administered Filgrastim following single doses to healthy volunteers. Pharm. Sci. 1(1): S-471 (1998).
H. Tanaka and T. Tokiwa. Influence of renal and hepatic failure on the pharmacokinetics of recombinant human granulocyte colony-stimulating factor (KRN8601) in the rat. Cancer Res. 50: 6615–6619 (1990).
G. Morstyn, L. Campbell, L. M. Souza, N. K. Alton, J. Keech, M. Green, W. Sheridan, D. Metcalf, and R. Fox. Effect of granulocyte colony stimulating factor on neutropenia induced by cytotoxic chemotherapy. Lancet 1: 667–672 (1988).
G. Molineux and T. M. Dexter. Biology of G-CSF. In G. Morstyn, T. M. Dexter, and M. Foote (eds.), Filgrastim (r-meHuG-CSF) in Clinical Practice, 2nd Ed., Marcel Dekker, New York, 1998, p. 17.
D. P. Stites, A. I. Terr, and T. G. Parslow. Basic and Clinical Immunology, 8th Ed., Appleton and Lance, Norwalk, CT, 1994, p. 10.
S. L. Beal and L. B. Sheiner. Handout, Intermediate Workshop in Population Pharmacokinetic Data Analysis Using the NONMEM System (Lecture 3, page 5), San Francisco, April 23–24, 1998.
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Wang, B., Ludden, T.M., Cheung, E.N. et al. Population Pharmacokinetic–Pharmacodynamic Modeling of Filgrastim (r-metHuG-CSF) in Healthy Volunteers. J Pharmacokinet Pharmacodyn 28, 321–342 (2001). https://doi.org/10.1023/A:1011534529622
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DOI: https://doi.org/10.1023/A:1011534529622