Pkpd 032

Dose [-concentration]-effect relationships can be obtained by fitting a predictive pharmacokinetic PK -pharmacodynamic PD model to both concentration and effect observations. Either a model can befit simultaneously to all the data "simultaneous" method , or first a model can befit to the PK data and then a model can be fit to the PD data, conditioning in some way on the PK data or on the estimates of the PK parameters "sequential" method. Using simulated data, we compare the performance of the simultaneous method with that of three sequential method variants with respect to computation time, estimation precision, and inference. Using NONMEM, under various study designs, observations of one type of PK and one type of PD response from different numbers of individuals were simulated according to a one-compartment PK model and direct Emax PD model, with parameters drawn from an appropriate population distribution. The same PK and PD models were fit to these observations using simultaneous and sequential methods. Performance measures include computation time,fraction of cases for which estimates are successfully obtained, precision of PD parameter estimates, precision of PD parameter standard error estimates, and type-I error rates of a likelihood ratio test. With the sequential method, computation time is less, and estimates are more likely to be obtained. Type-I error rates of likelihood ratio test for both simultaneous and sequential approaches are close to the nominal rates.
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