Population pharmacokinetics/pharmacodynamics of 3, 4‐diaminopyridine free base in patients with Lambert‐Eaton myasthenia

N Thakkar, JT Guptill, K Aleš, D Jacobus… - CPT …, 2017 - Wiley Online Library
N Thakkar, JT Guptill, K Aleš, D Jacobus, L Jacobus, C Peloquin, M Cohen‐Wolkowiez…
CPT: Pharmacometrics & Systems Pharmacology, 2017Wiley Online Library
Lambert‐Eaton myasthenia (LEM) is a rare autoimmune disorder associated with
debilitating muscle weakness. There are limited treatment options and 3, 4‐diaminopyridine
(3, 4‐DAP) free base is an investigational orphan drug used to treat LEM‐related weakness.
We performed a population pharmacokinetic/pharmacodynamic (PK/PD) analysis using 3, 4‐
DAP and metabolite concentrations collected from a phase II study in patients with LEM. The
Triple Timed Up & Go (3TUG) assessment, which measures lower extremity weakness, was …
Lambert‐Eaton myasthenia (LEM) is a rare autoimmune disorder associated with debilitating muscle weakness. There are limited treatment options and 3,4‐diaminopyridine (3,4‐DAP) free base is an investigational orphan drug used to treat LEM‐related weakness. We performed a population pharmacokinetic/pharmacodynamic (PK/PD) analysis using 3,4‐DAP and metabolite concentrations collected from a phase II study in patients with LEM. The Triple Timed Up & Go (3TUG) assessment, which measures lower extremity weakness, was the primary outcome measure. A total of 1,270 PK samples (49 patients) and 1,091 3TUG data points (32 randomized patients) were included in the PK/PD analysis. A two‐compartment and one‐compartment model for parent and metabolite, respectively, described the PK data well. Body weight and serum creatinine partially explained the variability in clearance for the final PK model. A fractional inhibitory maximum effect (Emax) model characterized the exposure‐response relationship well. The PK/PD model was applied to identify a suggested dosing approach for 3,4‐DAP free base.
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