» Articles » PMID: 27721364

Pediatric Dosing and Body Size in Biotherapeutics

Overview
Journal Pharmaceutics
Publisher MDPI
Date 2016 Oct 11
PMID 27721364
Citations 13
Authors
Affiliations
Soon will be listed here.
Abstract

Although pediatric doses for biotherapeutics are often based on patients' body weight (mg/kg) or body surface area (mg/m²), linear body size dose adjustment is highly empirical. Growth and maturity are also important factors that affect the absorption, distribution, metabolism and excretion (ADME) of biologics in pediatrics. The complexity of the factors involved in pediatric pharmacokinetics lends to the reconsideration of body size based dose adjustment. A proper dosing adjustment for pediatrics should also provide less intersubject variability in the pharmacokinetics and/or pharmacodynamics of the product compared with no dose adjustment. Biological proteins and peptides generally share the same pharmacokinetic principle with small molecules, but the underlying mechanism can be very different. Here, pediatric and adult pharmacokinetic parameters are compared and summarized for selected biotherapeutics. The effect of body size on the pediatric pharmacokinetics for these biological products is discussed in the current review.

Citing Articles

Desensitizing the autonomic nervous system to mitigate anti-GD2 monoclonal antibody side effects.

Mora J, Climent A, Roldan M, Flores M, Varo A, Perez-Jaume S Front Oncol. 2024; 14:1380917.

PMID: 38812778 PMC: 11134175. DOI: 10.3389/fonc.2024.1380917.


Real-world evidence on the dosing and safety of C.E.R.A. in pediatric dialysis patients: findings from the International Pediatric Dialysis Network registries.

Kohlhas L, Studer M, Rutten-Jacobs L, Reigner S, Sander A, Yap H Pediatr Nephrol. 2023; 39(3):807-818.

PMID: 37566114 PMC: 10817843. DOI: 10.1007/s00467-023-05977-z.


Altered Response Pattern following AZD5582 Treatment of SIV-Infected, ART-Suppressed Rhesus Macaque Infants.

Bricker K, Obregon-Perko V, Williams B, Oliver D, Uddin F, Neja M J Virol. 2022; 96(7):e0169921.

PMID: 35293766 PMC: 9006931. DOI: 10.1128/jvi.01699-21.


A population physiologically-based pharmacokinetic model to characterize antibody disposition in pediatrics and evaluation of the model using infliximab.

Chang H, Shakhnovich V, Frymoyer A, Funk R, Becker M, Park K Br J Clin Pharmacol. 2021; 88(1):290-302.

PMID: 34189743 PMC: 8714867. DOI: 10.1111/bcp.14963.


Physiologically Based Pharmacokinetic Modeling of Monoclonal Antibodies in Pediatric Populations Using PK-Sim.

Basu S, Lien Y, Vozmediano V, Schlender J, Eissing T, Schmidt S Front Pharmacol. 2020; 11:868.

PMID: 32595502 PMC: 7300301. DOI: 10.3389/fphar.2020.00868.


References
1.
Gale R, Hird M, Colvin B . Management of a premature infant with moderate haemophilia A using recombinant factor VIII. Haemophilia. 1999; 4(6):850-3. DOI: 10.1046/j.1365-2516.1998.00201.x. View

2.
Macdougall I, Gray S, Elston O, Breen C, Jenkins B, Browne J . Pharmacokinetics of novel erythropoiesis stimulating protein compared with epoetin alfa in dialysis patients. J Am Soc Nephrol. 1999; 10(11):2392-5. DOI: 10.1681/ASN.V10112392. View

3.
Kovarik J, Kahan B, Rajagopalan P, Bennett W, Mulloy L, Gerbeau C . Population pharmacokinetics and exposure-response relationships for basiliximab in kidney transplantation. The U.S. Simulect Renal Transplant Study Group. Transplantation. 1999; 68(9):1288-94. DOI: 10.1097/00007890-199911150-00012. View

4.
Peters A, Henderson B, Lui D . Indexed glomerular filtration rate as a function of age and body size. Clin Sci (Lond). 2000; 98(4):439-44. View

5.
Mortensen H, Lindholm A, Olsen B, Hylleberg B . Rapid appearance and onset of action of insulin aspart in paediatric subjects with type 1 diabetes. Eur J Pediatr. 2000; 159(7):483-8. DOI: 10.1007/s004310051315. View