Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019
Chloroquine (CQ) efficacy was shown in some coronavirus disease 2019 (COVID-19) adult clinical studies. However, its data in children is still limited. Therefore, this study aims to assess the suitability of the dosage regimens from the literature and regimens proposed by the authors for pediatric C...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Faculty of Pharmacy, Mahidol University
2022-07-01
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| Series: | Pharmaceutical Sciences Asia |
| Subjects: | |
| Online Access: | https://pharmacy.mahidol.ac.th/journal/_files/2022-49-4_3.pdf |
| _version_ | 1818042126393409536 |
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| author | Kiatkriangkrai Koyratkoson Nattapong Tidwong Suwida Tangtrakultham Preecha Montakantikul |
| author_facet | Kiatkriangkrai Koyratkoson Nattapong Tidwong Suwida Tangtrakultham Preecha Montakantikul |
| author_sort | Kiatkriangkrai Koyratkoson |
| collection | DOAJ |
| description | Chloroquine (CQ) efficacy was shown in some coronavirus disease 2019 (COVID-19) adult clinical studies. However, its data in children is still limited. Therefore, this study aims to assess the suitability of the dosage regimens from the literature and regimens proposed by the authors for pediatric COVID-19 patients aged 2-12 years old. The efficacy pharmacodynamic (PD) target was calculated for CQ blood concentration based on the literature’s successfully treated COVID-19 adult regimen. The safety PD targets were derived from the literature regarding any adverse effects (AEs) and QTc prolongation. The adult pharmacokinetic (PK) parameters were transformed into pediatrics by allometric scaling (AS) method. A 10,000-time Monte Carlo simulation (MCS) was performed to calculate the percentage of probability to target attainment (%PTA). The literature’s regimens were not capable of achieving 90%PTA efficacy PD target. The proposed regimens without loading dose (LD) achieved the efficacy target at day 8-10 which was later than the proposed regimens with LD (day 4-7). The 90%PTA below any AEs target was achieved in the first few days of the literature and proposed regimens but was unavoidable thereafter. Nevertheless, the 90%PTA below QTc prolongation target was favorably achieved by all regimens. This study revealed that the proposed regimen with LD seems to be the optimal dosage regimen. Additional studies are needed to validate our proposed regimens, especially among early-stage COVID-19 patients and recent major variants. |
| first_indexed | 2024-12-10T08:41:22Z |
| format | Article |
| id | doaj.art-311eec0062d14542ad26a65b0f64e167 |
| institution | Directory Open Access Journal |
| issn | 2586-8470 |
| language | English |
| last_indexed | 2024-12-10T08:41:22Z |
| publishDate | 2022-07-01 |
| publisher | Faculty of Pharmacy, Mahidol University |
| record_format | Article |
| series | Pharmaceutical Sciences Asia |
| spelling | doaj.art-311eec0062d14542ad26a65b0f64e1672022-12-22T01:55:51ZengFaculty of Pharmacy, Mahidol UniversityPharmaceutical Sciences Asia2586-84702022-07-0149431232210.29090/psa.2022.04.22.040Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019Kiatkriangkrai Koyratkoson0Nattapong Tidwong1Suwida Tangtrakultham2Preecha Montakantikul3Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandDepartment of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandChloroquine (CQ) efficacy was shown in some coronavirus disease 2019 (COVID-19) adult clinical studies. However, its data in children is still limited. Therefore, this study aims to assess the suitability of the dosage regimens from the literature and regimens proposed by the authors for pediatric COVID-19 patients aged 2-12 years old. The efficacy pharmacodynamic (PD) target was calculated for CQ blood concentration based on the literature’s successfully treated COVID-19 adult regimen. The safety PD targets were derived from the literature regarding any adverse effects (AEs) and QTc prolongation. The adult pharmacokinetic (PK) parameters were transformed into pediatrics by allometric scaling (AS) method. A 10,000-time Monte Carlo simulation (MCS) was performed to calculate the percentage of probability to target attainment (%PTA). The literature’s regimens were not capable of achieving 90%PTA efficacy PD target. The proposed regimens without loading dose (LD) achieved the efficacy target at day 8-10 which was later than the proposed regimens with LD (day 4-7). The 90%PTA below any AEs target was achieved in the first few days of the literature and proposed regimens but was unavoidable thereafter. Nevertheless, the 90%PTA below QTc prolongation target was favorably achieved by all regimens. This study revealed that the proposed regimen with LD seems to be the optimal dosage regimen. Additional studies are needed to validate our proposed regimens, especially among early-stage COVID-19 patients and recent major variants.https://pharmacy.mahidol.ac.th/journal/_files/2022-49-4_3.pdfchloroquinecovid-19monte carlo simulationpediatricspharmacokinetics |
| spellingShingle | Kiatkriangkrai Koyratkoson Nattapong Tidwong Suwida Tangtrakultham Preecha Montakantikul Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 Pharmaceutical Sciences Asia chloroquine covid-19 monte carlo simulation pediatrics pharmacokinetics |
| title | Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| title_full | Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| title_fullStr | Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| title_full_unstemmed | Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| title_short | Chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| title_sort | chloroquine dosage regimen simulation for pediatric patients with coronavirus disease 2019 |
| topic | chloroquine covid-19 monte carlo simulation pediatrics pharmacokinetics |
| url | https://pharmacy.mahidol.ac.th/journal/_files/2022-49-4_3.pdf |
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