An alternative method for population pharmacokinetic data analysis under noncompliance

摘要

Noncompliance presents a persistent problem while analyzing PK data from outpatient clinical studies. Ignoring dose omission or making uninformed assumptions about patient drug intake history can prove detrimental to the objectives of the analysis (e.g. determining the PK model parameters or identifying covariates) and ultimately compromise the interpretation of the data. In order to overcome this problem, an alternative method of handling noncompliant data is evaluated in this report. The proposed approach is based on the principle of superposition and works by separating the estimation of the elimination rate from the model based steady-state PK concentration. Simulations implementing this method under different scenarios of noncompliance demonstrate that it performs better than the conventional method of analyzing population PK data when compared on the basis of bias and imprecision in parameter estimation and power (and type I error) for covariate detection. Overall, the new method exhibits great potential to address the issue of uncertain/unreliable dosing histories frequently encountered in clinical trials.