Predictability of Individualized Dosage Regimens of Carbamazepine and Valproate Mono- and Combination Therapy

摘要

What is Known and ObjectiveMany investigators agree that appropriate rational utilization of therapeutic drug monitoring (TDM) with Bayesian feedback dosage adjustment facilitates epilepsy treatment with carbamazepines and/or valproates by increasing the seizure control and safety, as well as by reducing treatment costs. In previous works we have developed and used in clinical practice population pharmacokinetic (PK) models of different dosage forms for valproate (VPA) and post – induction carbamazepine (CBZ) behaviour as well as for combined therapy with CBZ plus another “old” antiepileptic drug (AED). An important step of external validation is to evaluate how well a procedure of Bayesian individualizing AED dosage regimens based on a proposed population PK model and sparse TDM data “works”, and how helpful it is in real practical clinical settings.The aim of this study was to evaluate the predictability of individualized dosage regimens for monotherapy with CBZ in the post-induction period or with VPA, as well as for CBZ and VPA given as combination therapy based on TDM data of epileptic patients and the earlier developed population models.