Evidence map›Paper›PMID 37256410›Full record

ArticleEuropean journal of clinical pharmacology2023

Failure to predict amikacin elimination in critically ill patients with cancer based on the estimated glomerular filtration rate: applying PBPK approach in a therapeutic drug monitoring study.

João Paulo Telles, Mariana Suelotto Diegues, Karen Cristina Migotto, Olivia de Souza Borges, Rodrigo Reghini, Brenda Vianna Gavazza, Leonardo Pinto, Pedro Caruso, Ivan Leonardo França E Silva, Stephan Schmidt and 1 more

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Article in European journal of clinical pharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

João Paulo TellesDepartment of Infectious Diseases, AC Camargo Cancer Center, Professor Antonio Prudente Street, N. 211, São Paulo-SP, 01509-001, Brazil. jpmarochi@hotmail.com.
Mariana Suelotto DieguesDepartment of Clinical Pharmacy, AC Camargo Cancer Center, São Paulo-SP, Brazil.
Karen Cristina MigottoDepartment of Clinical Pharmacy, AC Camargo Cancer Center, São Paulo-SP, Brazil.
Olivia de Souza BorgesDepartment of Clinical Pharmacy, AC Camargo Cancer Center, São Paulo-SP, Brazil.
Rodrigo ReghiniDepartment of Infectious Diseases, AC Camargo Cancer Center, Professor Antonio Prudente Street, N. 211, São Paulo-SP, 01509-001, Brazil.
Brenda Vianna GavazzaFaculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil.
Leonardo PintoLaboratory of Immunopathology, Nucleus of Biological Sciences Research, Federal University of Ouro Preto, Ouro Preto-MG, Brazil.
Pedro CarusoDepartment of Intensive Care Unit, AC Camargo Cancer Center, São Paulo-SP, Brazil.
Ivan Leonardo França E SilvaDepartment of Infectious Diseases, AC Camargo Cancer Center, Professor Antonio Prudente Street, N. 211, São Paulo-SP, 01509-001, Brazil.
Stephan SchmidtDepartment of Pharmaceutics Lake Nona, University of Florida, Orlando-FL, USA.
Fernanda de Lima MoreiraFaculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro-RJ, Brazil.
AC Camargo Hospital · BRUniversidade Federal do Rio de Janeiro · BRUniversidade Federal de Ouro Preto · BRUniversity of Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this work was to integrate the Therapeutic Drug Monitoring (TDM) with the model-informed precision dosing (MIPD) approach, using Physiologically-based Pharmacokinetic/Pharmacodynamic (PBPK/PD) modelling and simulation, to explore the relationship between amikacin exposure and estimated glomerular filtration rate (GFR) in critically ill patients with cancer.

methodsIn the TDM study, samples from 51 critically-ill patients with cancer treated with amikacin were analysed. Patients were stratified according to renal function based on GFR status. A full-body PBPK model with 12 organs model was developed using Simcyp V. 21, including steady-state volume of distribution of 0.21 L/kg and renal clearance of 6.9 L/h in healthy adults. PK parameters evaluated were within the 2-fold error range.

resultsDuring the validation step, predicted vs observed amikacin clearance values after single infusion dose in patients with normal renal function, mild and moderate renal impairment were 7.6 vs 8.1 L/h (7.5 mg/kg dose); 3.8 vs 4.5 L/h (1500 mg dose) and 2.2 vs 3.1 L/h (25 mg/kg dose), respectively. However, predicted vs observed amikacin clearance after a single dose infusion of 1400 mg in critically-ill patients with cancer were 1.46 vs 1.63 (P = 0.6406) L/h (severe), 2.83 vs 1.08 (P < 0.05) L/h (moderate), 4.23 vs 2.49 (P = 0.0625) L/h (mild) and 7.41 vs 3.36 (P < 0.05) L/h (normal renal function).

conclusionThis study demonstrated that estimated GFR did not predict amikacin elimination in critically-ill patients with cancer. Further studies are necessary to find amikacin PK covariates to optimize the pharmacotherapy in this population. Therefore, TDM of amikacin is imperative in cancer patients.

Indexed as

AmikacinNeoplasmsAdultAnti-Bacterial AgentsCritical IllnessDrug MonitoringGlomerular Filtration RateHumansAmikacinAnti-Bacterial AgentsAminoglycosideModel informed precision dosingPharmacokineticsPhysiologically based pharmacokinetics

Identifiers

PMID37256410
OpenAlexW4378782529

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.