Modeling of the LDL cholesterol-lowering effect of atorvastatin in Korean dyslipidemic patients and non-patient volunteers

Int J Clin Pharmacol Ther. 2012 Sep;50(9):647-56. doi: 10.5414/cp201699.

Abstract

Objective: The aim of this study was to develop a longitudinal pharmacodynamic model describing the time-courses of low-density lipoprotein cholesterol (LDL) profiles during and after atorvastatin treatment in Korean dyslipidemic patients and non-patient volunteers.

Methods: 15 dyslipidemic patients and 11 non-patient volunteers with no prior therapy participated in a parallel, 2-step dose escalation study. Subjects received atorvastatin doses ranging from 10 to 80 mg for 42 days (dyslipidemic patients) or 10 mg for 21 days (non-patient volunteers). Plasma samples were collected before and during the treatment period and up to 2 weeks after the last administration. A population pharmacodynamic model was built using the NONMEM software package. An indirect response model consisting of production in hepatocyte and elimination from plasma stimulated by atorvastatin described the LDL time-course.

Results: The typical population value of the estimated dose producing 50% of maximal stimulation on LDL elimination (SD50) for dyslipidemic patients was 11.9 mg, which was about 6 times higher than that of non-patient volunteers (2.0 mg).

Conclusion: A longitudinal population pharmacodynamic model for the LDL-lowering effect of atorvastatin in both dyslipidemic patients and non-patient volunteers was developed. This could help guide optimal therapies according to the target population.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asian People*
  • Atorvastatin
  • Biomarkers / blood
  • Cholesterol, LDL / blood*
  • Computer Simulation
  • Decision Support Techniques
  • Down-Regulation
  • Drug Administration Schedule
  • Drug Dosage Calculations
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / ethnology
  • Female
  • Heptanoic Acids / administration & dosage
  • Heptanoic Acids / blood
  • Heptanoic Acids / pharmacokinetics*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / blood
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacokinetics*
  • Male
  • Middle Aged
  • Models, Biological*
  • Pyrroles / administration & dosage
  • Pyrroles / blood
  • Pyrroles / pharmacokinetics*
  • Republic of Korea / epidemiology
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers
  • Cholesterol, LDL
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Atorvastatin