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In the development of CNS-targeted drugs, the prediction of human CNS target exposure is a big challenge.
The challenge of defining the concentration of unbound drug at the lung target site after inhalation limits the possibility to optimize target exposure by compound design.
For illustration, BioRAM is applied to four relatively common therapy‐driven drug delivery scenarios: rapid therapeutic onset, multiphasic delivery, delayed therapeutic onset, and maintenance of target exposure.
Target exposure concentrations included a total NPE/OPE mixture load of 200% of the WWTP effluent concentration (148 μg/L), 100% of the WWTP effluent concentration (74 μg/L) and 50% of the WWTP effluent concentration (38 μg/L).
They show that target exposure to the HML factor is statistically insignificant in the one to three years prior to the activist intervention, peaks in the first year after, and declines to a lower level in the following one to three years.
The limited plasma concentration data in the remaining two patients were not inconsistent with the target exposure being reached.
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However, discovery teams duly spend considerable time and resources on structure activity optimization and formulation-enabled drug delivery technologies to achieve the target exposures and biopharmaceutical properties, when early implementation of prodrugs could lead to an improved drug molecule.
No neonate who received a lower dosing regimen achieved this target.In neonates with HIE receiving hypothermia, Epo 1,000 U/kg every 24 h for the first 2 d of therapy resulted in consistent achievement of target exposures associated with neuroprotection in animal models.Pediatric Research (2017); doi:10.1038/pr.2017.15.
In addition, the reported PK variability of these antibiotics suggests that many patients do not achieve their target exposures.
To the extent that it is scientifically justified, new studies should consider harmonizing some target exposures with existing studies.
Boldface represents those CLCR values where target exposures would be achieved in at least 80% of isolates.
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CEO of Professional Science Editing for Scientists @ prosciediting.com