Journal
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
Volume 77, Issue 4, Pages 583-593Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00228-020-03032-6
Keywords
Chloroquine; Population pharmacokinetics; Coronavirus disease 2019
Categories
Funding
- Ministry of Science and Technology (MOST) of the People's Republic of China foundation for SARS-nCov-2 Research [2020YFC0844500]
- Bill & Melinda Gates Foundation [INV-015694]
- Bill and Melinda Gates Foundation [INV-015694] Funding Source: Bill and Melinda Gates Foundation
Ask authors/readers for more resources
The study developed a population PK model to characterize CQ PK in COVID-19 patients and found that the currently recommended dosing regimen is generally safe within the safety margin.
Aims Chloroquine (CQ) has been repurposed to treat coronavirus disease 2019 (COVID-19). Understanding the pharmacokinetics (PK) in COVID-19 patients is essential to study its exposure-efficacy/safety relationship and provide a basis for a possible dosing regimen optimization. Subject and methods In this study, we used a population-based meta-analysis approach to develop a population PK model to characterize the CQ PK in COVID-19 patients. An open-label, single-center study (ethical review approval number: PJ-NBEY-KY-2020-063-01) was conducted to assess the safety, efficacy, and pharmacokinetics of CQ in patients with COVID-19. The sparse PK data from 50 COVID-19 patients, receiving 500 mg CQ phosphate twice daily for 7 days, were combined with additional CQ PK data from 18 publications. Results A two-compartment model with first-order oral absorption and first-order elimination and an absorption lag best described the data. Absorption rate (ka) was estimated to be 0.559 h(-1), and a lag time of absorption (ALAG) was estimated to be 0.149 h. Apparent clearance (CL/F) and apparent central volume of distribution (V2/F) was 33.3 l/h and 3630 l. Apparent distribution clearance (Q/F) and volume of distribution of peripheral compartment (Q3/F) were 58.7 l/h and 5120 l. The simulated CQ concentration under five dosing regimens of CQ phosphate were within the safety margin (400 ng/ml). Conclusion Model-based simulation using PK parameters from the COVID-19 patients shows that the concentrations under the currently recommended dosing regimen are below the safety margin for side-effects, which suggests that these dosing regimens are generally safe. The derived population PK model should allow for the assessment of pharmacokinetics-pharmacodynamics (PK-PD) relationships for CQ when given alone or in combination with other agents to treat COVID-19.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available