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Table 2 Parameter estimates of the final pharmacokinetic-pharmacodynamic model

From: Population pharmacokinetic and pharmacodynamic properties of artesunate in patients with artemisinin sensitive and resistant infections in Southern Myanmar

Parameter

Estimates (% RSE)

95% CI

%CV BSV (% RSE)

95% CI

Pharmacokinetics

 Artesunate

  F (%)

100 fix

–

31.2 (29.4)

19.3–50.8

  MTT (h)

1.34 (18.8)

1.04–1.96

85.3 (24.9)

65.7–133.0

  CLARS/F (l/h)

1750 (8.55)

1570–2090

26.8 (44.3)

11.9–39.1

  VARS/F (l)

1300 (12.6)

1110–1660

74.7 (27.3)

57.8–129

  RUV (%)

73.2 (3.95)

69.3–78.7

–

–

 Dihydroartemisinin

  CLDHA/F (l/h)

76.7 (6.99)

69.9–87.8

21.3 (30.3)

13.3–88.1

  VDHA/F (l)

102.0 (8.95)

89.5–119.0

31.6 (40.5)

21.3–131.0

  RUV (%)

58.5 (3.34)

56.6–63.4

–

–

 Covariate effects

  aPARAMTT (Log10 parasitaemia)

0.115 (8.88)

0.121–0.156

–

–

  aPARAmaxF

1.51 (11.9)

1.35–2.02

–

–

  aPARA50F (Log10 parasitaemia)

8.32 (3.58)

8.19–9.21

–

–

 Pharmacodynamics

  KGROWTH (48 h−1)

10 fix

 

–

 

  BASEPARA (Log10)

11.0 (0.704)

10.8–11.1

4.4 (19.6)

3.13–5.78

  ke0 (h−1)

0.123 (33.1)

0.0584–0.188

–

 

  aEC50 (nM)

30.4 (34.2)

13.5–46.1

–

 

  aEmaxS (h−1)

0.268 (5.89)

0.242–0.295

b49.0 (22.4)

34.3–70.1

  EmaxR (h−1)

0.155 (6.08)

0.142–0.172

12.2 (45.5)

6.54–35.8

  PMIX, resistant (%)

56.1 (20.9)

39.1–73.8

–

 

  RUV (%)

33.3 (5.91)

30.5–37.1

–

 
  1. Coefficient of variation (%CV) of between subject variability (BSV) was calculated as 100 × (variance-1)1/2. Relative standard errors (% RSE) were calculated as 100 × (standard deviation/mean). The 95% confidence intervals (95% CI) of parameter estimates were obtained with the Sampling Importance Resampling (SIR) approach
  2. ARS artesunate, BASE PARA baseline parasitaemia, CL clearance, DHA dihydroartemisinin, F bioavailability, K GROWTH parasite multiplication per 48 h parasite cycle, MTT mean transit time, PARA MTT estimated linear effect of parasite density on MTT, PARAmax F maximum effect of parasite density on F, PARA50 F parasite density which produces 50% of the maximum covariate response, P MIX, resistant probability of having an artemisinin-resistant infection, V volume of distribution, EC 50 the DHA concentration which produces 50% of maximum parasite killing effect, Emax R maximum parasite killing effect of a resistant parasite population, Emax S maximum parasite killing effect of a sensitive parasite population, k e0 effect compartment rate constant governing the delayed drug effect, RUV unexplained residual variability
  3. aEstimation of these parameters were obtained by applying a frequentist prior approach using a previously published PK/PD model developed on data from Thailand and Cambodia (37)
  4. bBSV (%CV) of EmaxS was calculated based on simulations (10,000 patients) with an estimated variance of 0.430 and the applied transformation presented in Eq. 7