Exposure–Response Modeling in Adults and Adolescents With Schizophrenia to Support the Extrapolation of Brexpiprazole Efficacy to Adolescents.

In order to accelerate drug development and avoid unnecessary drug trials in vulnerable pediatric populations, the US Food and Drug Administration (FDA) released a general advice letter to sponsors permitting the effectiveness of atypical antipsychotics for the treatment of schizophrenia in adults t...

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Publicado en:Journal of Clinical Pharmacology Vol. 64; no. 10; pp. 1236 - 1246
Autores principales: Wang, Xiaofeng, Gopalakrishnan, Mathangi, Rich, Benjamin, Gobburu, Jogarao V., Larsen, Frank, Raoufinia, Arash
Formato: equations & formulas research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2024
      vid: 64
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      pub: Wiley-Blackwell
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        10.1002/jcph.2464
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        atl: Exposure–Response Modeling in Adults and Adolescents With Schizophrenia to Support the Extrapolation of Brexpiprazole Efficacy to Adolescents.
      aug:
        au:
          Wang, Xiaofeng
          Gopalakrishnan, Mathangi
          Rich, Benjamin
          Gobburu, Jogarao V.
          Larsen, Frank
          Raoufinia, Arash
        affil: Otsuka Pharmaceutical Development & Commercialization Inc., Princeton NJ,, USA
      sug:
        subj:
          Schizophrenia Drug Therapy
          Schizophrenia Drug Therapy
          Schizophrenia Symptoms
          Antipsychotic Agents Therapeutic Use
          Aripiprazole Administration and Dosage
          Drug Efficacy Evaluation
          Drug Monitoring
          Human
          Adolescence
          Adult
          Quantitative Studies
          Dose-Response Relationship, Drug
          Scales
          Patient Dropouts
          Models, Theoretical
          Age of Onset
          United States Food and Drug Administration
          Treatment Outcomes
          Disease Attributes
          Dopamine Agents
          Serotonin Agents
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
      ab: In order to accelerate drug development and avoid unnecessary drug trials in vulnerable pediatric populations, the US Food and Drug Administration (FDA) released a general advice letter to sponsors permitting the effectiveness of atypical antipsychotics for the treatment of schizophrenia in adults to be extrapolated to adolescents. Extrapolation is based on the evidence‐based assumptions that (1) disease characteristics and (2) response to therapy, are similar in adults and adolescents. Whereas the FDA validated the extrapolation approach using data from multiple drug development programs, aripiprazole data are the most relevant to confirm the validity of the extrapolation approach for brexpiprazole, since aripiprazole and brexpiprazole both modulate dopaminergic and serotonergic signaling in the brain. The aims of this analysis were (1) to quantitatively assess the aripiprazole exposure (average steady‐state concentration)–response (Positive and Negative Syndrome Scale total score change from baseline) similarity between adults and adolescents with schizophrenia, (2) to extend the aripiprazole exposure–response modeling to brexpiprazole using adult data, and (3) to use the brexpiprazole model to predict schizophrenia symptom response in adolescents. Disease–drug–dropout models were developed using patient‐level data from clinical studies of aripiprazole (1007 adults, 294 adolescents) and brexpiprazole (1235 adults) in schizophrenia. The aripiprazole model demonstrated similar exposure–response between adults and adolescents with schizophrenia, validating the extrapolation approach. Extrapolation of the brexpiprazole adult exposure–response model to adolescents predicted the efficacy of brexpiprazole in adolescents aged 13‐17 years with schizophrenia.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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