ArticleBritish journal of anaesthesia2025
Development and analysis of a remimazolam pharmacokinetics and pharmacodynamics model with proposed dosing and concentrations for anaesthesia and sedation.
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Remimazolam in pediatric anesthesia: a systematic review for clinical decision-making.Frontiers in pediatrics · 2025Pooled it
- Effects of Remimazolam Dose and Bolus Injection Rate on Hiccups During Painless Colonoscopy: A Double-Blind Randomized Clinical Trial.Drug design, development and therapy · 2026Trial
- A VOSviewer® and iCite®-based bibliometric study on target-controlled infusions in anaesthesia.Indian journal of anaesthesia · 2026Article
- Remimazolam besylate in the intensive care unit: emerging evidence, unresolved questions, and a potential clinical niche.Intensive care medicine · 2026Article
- Efficacy and safety of remimazolam besylate in patients receiving mechanical ventilation: A randomized phase Ⅱa trial.Journal of intensive medicine · 2026Article
- Association Between American Society of Anesthesiologists Physical Status Classification System and Remimazolam Sedation Outcomes.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Pharmacological profiles and mechanism of action of remimazolam for ICU sedation.Journal of intensive care · 2026Review
- Safety and efficacy of remimazolam in critical illness.Journal of intensive care · 2026Review
- Age-Stratified EDDrug design, development and therapy · 2026Article
- Effects of Remimazolam Dose and Bolus Injection Rate on Hiccups During Painless Colonoscopy: A Double-Blind Randomized Clinical Trial [Letter].Drug design, development and therapy · 2026Article
- Efficacy and safety of remimazolam for sedation in gastrointestinal endoscopy: a systematic review and meta-analysis.Frontiers in medicine · 2026Review
- Effects of Remimazolam Dose and Bolus Injection Rate on Hiccups During Painless Colonoscopy: A Double-Blind Randomized Clinical Trial [Response to Letter].Drug design, development and therapy · 2026Article
- Optimal Dosing Strategies for Remimazolam Across Diverse Patient Populations: A Clinical Narrative Review.Drug design, development and therapy · 2026Review
- Delirium in Extracorporeal Membrane Oxygenation (ECMO) Patients: A Systematic Review and Meta-Analysis of Prevalence, Risk Factors, and Outcomes.Journal of clinical medicine · 2025Review
- Relationship between effect site concentration of remimazolam at loss of consciousness and time to extubation: a prospective, single-centre, observational study.Journal of clinical monitoring and computing · 2025Observational
- Review
- Clinical Pharmacokinetics and Pharmacodynamics of Remimazolam.Clinical pharmacokinetics · 2025Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPharmacokinetic-pharmacodynamic (PK-PD) models of remimazolam and their covariate relationships are useful for understanding drug disposition and predicting drug effects. Although clinical studies have shown that remimazolam induction doses decline with advancing age, this property is not reflected in existing models. The purpose of this investigation was to develop a PK-PD model for remimazolam and perform covariate analysis to maximise its utility across broad, diverse populations and to evaluate its consistency with clinical observations of drug dosing.
methodsArterial and venous concentrations of remimazolam and its metabolite, Modified Observer's Assessment of Alertness and Sedation score and bispectral index were determined in 20 studies. Final population models were developed with covariate analysis. Simulations of drug administration for sedation and anaesthesia for this and previously published models were compared with the results of clinical studies.
resultsModel development proceeded from 933 individuals aged 6-93 yr and weight 21-171 kg. PK data from studies with extracorporeal membrane oxygenation and treatment in ICU were considered in a post hoc analysis. Simulations of target-controlled infusion with the final model targeting sedation (Modified Observer's Assessment of Alertness and Sedation score 2 or 3) or anaesthesia (bispectral index 50) showed drug administration declining with age consistent with clinical observations.
conclusionsA PK-PD model for remimazolam was developed for a broad, diverse population. Dosing and target concentrations are proposed that are clinically useful for anaesthesia and sedation, especially for target-controlled infusion administration.
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