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A population pharmacokinetic model of methotrexate in Korean patients with hematologic malignancy
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  • YUN SEOB JUNG,
  • Mijeong Son,
  • Sang-Guk Lee,
  • June-Won Cheong,
  • Soo-Jeong Kim,
  • Ji eun Jang,
  • Chuhl Joo Lyu,
  • Seung Min Hahn,
  • Jung Woo Han,
  • Kyungsoo Park
YUN SEOB JUNG
Yonsei University Wonju College of Medicine
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Mijeong Son
Boryung Pharmaceutical Co Ltd
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Sang-Guk Lee
Yonsei University College of Medicine
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June-Won Cheong
Yonsei University College of Medicine
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Soo-Jeong Kim
Yongin Severance Hospital
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Ji eun Jang
Yonsei University College of Medicine
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Chuhl Joo Lyu
Yonsei University Health System
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Seung Min Hahn
Yonsei University College of Medicine
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Jung Woo Han
Yonsei University Health System
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Kyungsoo Park
Yonsei University College of Medicine

Corresponding Author:kspark@yuhs.ac

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Abstract

Aim: This study was conducted to develop a population pharmacokinetic (PK) model of methotrexate in Korean patients with hematologic malignancy, identify factors affecting methotrexate PK, and propose optimal dosage regimen for the Korean population. Methods: Data were retrospectively collected from 188 patients with acute leukemia or non-Hodgkin’s lymphoma who were admitted to Severance Hospital for the period from 2005 to 2015. Using demographic factors and laboratory results as potential covariates for PK parameters, model development was performed using NONMEM and optimal dosing regimens were developed using the final PK model. Results: A two-compartment model incorporating body weight via allometry best described the data, yielding typical parameter values of 25.99L for central volume of distribution (V_1), 18.76L for peripheral volume of distribution (V_2), 12.9L/h for clearance (CL) and 0.646L/h for inter-compartmental clearance. Covariate analyses showed that, at the weight of 50kg, CL decreased by 0.11 L/h for each one-year increase in age above 14 years old and decreased to 0.8-fold when serum creatinine level doubled, indicating the importance of age-specific dose individualization in methotrexate treatment. Volume of distribution at steady state derived from PK parameters (=V_1+V_2) was 0.90L/kg, which was similar to those in the Western or Chinese population. Optimal doses simulated from the final model successfully produced the PK measures close to the target chosen. Conclusion: The population PK model and optimal dosage regimens developed in this study can be used as a basis to achieve precision dosing in Korean patients with hematologic malignancy.
03 Feb 2023Submitted to British Journal of Clinical Pharmacology
04 Apr 2023Submission Checks Completed
04 Apr 2023Assigned to Editor
04 Apr 2023Review(s) Completed, Editorial Evaluation Pending
10 Apr 2023Reviewer(s) Assigned
02 Jun 2023Editorial Decision: Revise Major
21 Aug 20231st Revision Received
21 Aug 2023Submission Checks Completed
21 Aug 2023Assigned to Editor
21 Aug 2023Review(s) Completed, Editorial Evaluation Pending
23 Aug 2023Reviewer(s) Assigned
06 Sep 2023Editorial Decision: Revise Minor
14 Oct 2023Submission Checks Completed
14 Oct 2023Assigned to Editor
14 Oct 2023Review(s) Completed, Editorial Evaluation Pending
15 Oct 2023Reviewer(s) Assigned
01 Nov 2023Editorial Decision: Revise Minor
09 Nov 20233rd Revision Received
09 Nov 2023Submission Checks Completed
09 Nov 2023Assigned to Editor
09 Nov 2023Review(s) Completed, Editorial Evaluation Pending
14 Nov 2023Editorial Decision: Accept