The importance of clinical pharmacokinetic–pharmacodynamic studies in unraveling the determinants of early and late tuberculosis outcomes

Andrew D McCallum, Derek James Sloan

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Abstract

Tuberculosis remains a major infectious cause of morbidity and mortality worldwide. Current antibiotic regimens, constructed prior to the development of modern pharmacokinetic-pharmacodynamic (PK–PD) tools, are based on incomplete understanding of exposure–response relationships in drug susceptible and multidrug resistant tuberculosis. Preclinical and population PK data suggest that clinical PK–PD studies may enable therapeutic drug monitoring for some agents and revised dosingf or others. Future clinical PK–PD challenges include: incorporation of PK methods to assay free concentrations for all active metabolites; selection of appropriate early outcome measures which reflect therapeutic response; elucidation of genetic contributors to interindividual PK variability; conduct of targeted studies on special populations (including children); and measurement of PK–PD parameters at the site of disease.
Original languageEnglish
Pages (from-to)195-212
JournalInternational Journal of Pharmacokinetics
Volume2
Issue number3
Early online date12 Jul 2017
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Clinical trials
  • Compartmental pharmacokinetics
  • Multidrug-resistant tuberculosis
  • Pharmacogenetics
  • Pharmacokinetics-pharmacodynamics
  • Therapeutic drug monitoring
  • Tuberculosis

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