Computational pharmacokinetics/pharmacodynamics of rifampin in a mouse tuberculosis infection model

J Pharmacokinet Pharmacodyn. 2015 Aug;42(4):375-89. doi: 10.1007/s10928-015-9419-z. Epub 2015 May 31.

Abstract

One critical approach to preclinical evaluation of anti-tuberculosis (anti-TB) drugs is the study of correlations between drug exposure and efficacy in animal TB infection models. While such pharmacokinetic/pharmacodynamic (PK/PD) studies are useful for the identification of optimal clinical dosing regimens, they are resource intensive and are not routinely performed. A mathematical model capable of simulating the PK/PD properties of drug therapy for experimental TB offers a way to mitigate some of the practical obstacles to determining the PK/PD index that best correlates with efficacy. Here, we present a preliminary physiologically based PK/PD model of rifampin therapy in a mouse TB infection model. The computational framework integrates whole-body rifampin PKs, cell population dynamics for the host immune response to Mycobacterium tuberculosis infection, drug-bacteria interactions, and a Bayesian method for parameter estimation. As an initial application, we calibrated the model to a set of available rifampin PK/PD data and simulated a separate dose fractionation experiment for bacterial killing kinetics in the lungs of TB-infected mice. The simulation results qualitatively agreed with the experimentally observed PK/PD correlations, including the identification of area under the concentration-time curve as best correlating with efficacy. This single-drug framework is aimed toward extension to multiple anti-TB drugs in order to facilitate development of optimal combination regimens.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antibiotics, Antitubercular / administration & dosage
  • Antibiotics, Antitubercular / pharmacokinetics*
  • Antibiotics, Antitubercular / therapeutic use
  • Bayes Theorem
  • Computer Simulation
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Drug Evaluation, Preclinical
  • Mice
  • Models, Biological*
  • Monte Carlo Method
  • Mycobacterium tuberculosis / drug effects*
  • Rifampin / administration & dosage
  • Rifampin / pharmacokinetics*
  • Rifampin / therapeutic use
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / metabolism

Substances

  • Antibiotics, Antitubercular
  • Rifampin