Prediction of the human in vivo antiplatelet effect of S- and R-indobufen using population pharmacodynamic modeling and simulation based on in vitro platelet aggregation test
	    		
		   		
		   			
		   		
	    	
    	 
    	10.12793/tcp.2018.26.4.160
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Yook Hwan NOH
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sungpil HAN
			        		
			        		;
		        		
		        		
		        		
			        		Sangmin CHOE
			        		
			        		;
		        		
		        		
		        		
			        		Jin Ah JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Jin Ah JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Ae Kyung HWANG
			        		
			        		;
		        		
		        		
		        		
			        		Hyeong Seok LIM
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Clinical Pharmacology and Therapeutics, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. mdhslim@gmail.com
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Dosage scheme;
			        		
			        		
			        		
				        		Indobufen;
			        		
			        		
			        		
				        		In vitro;
			        		
			        		
			        		
				        		NONMEM;
			        		
			        		
			        		
				        		Platelet aggregation;
			        		
			        		
			        		
				        		Population pharmacodynamics
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Blood Platelets;
				        		
			        		
				        		
					        		Colon, Sigmoid;
				        		
			        		
				        		
					        		Healthy Volunteers;
				        		
			        		
				        		
					        		Humans;
				        		
			        		
				        		
					        		In Vitro Techniques;
				        		
			        		
				        		
					        		Plasma;
				        		
			        		
				        		
					        		Platelet Aggregation;
				        		
			        		
				        		
					        		Platelet-Rich Plasma;
				        		
			        		
				        		
					        		Treatment Outcome
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Translational and Clinical Pharmacology
	            		
	            		 2018;26(4):160-165
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Indobufen (Ibustrin®), a reversible inhibitor of platelet aggregation, exists in two enantiomeric forms in 1:1 ratio. Here, we characterized the anti-platelet effect of S- and R-indobufen using response surface modeling using NONMEM® and predicted the therapeutic doses exerting the maximal efficacy of each enantioselective S- and R-indobufen formulation. S- and R-indobufen were added individually or together to 24 plasma samples from drug-naïve healthy subjects, generating 892 samples containing randomly selected concentrations of the drugs of 0–128 mg/L. Collagen-induced platelet aggregation in platelet-rich plasma was determined using a Chrono-log Lumi-Aggregometer. Inhibitory sigmoid I(max) model adequately described the anti-platelet effect. The S-form was more potent, whereas the R-form showed less inter-individual variation. No significant interaction was observed between the two enantiomers. The anti-platelet effect of multiple treatments with 200 mg indobufen twice daily doses was predicted in the simulation study, and the effect of S- or R-indobufen alone at various doses was predicted to define optimal dosing regimen for each enantiomer. Simulation study predicted that 200 mg twice daily administration of S-indobufen alone will produce more treatment effect than S-and R-mixture formulation. S-indobufen produced treatment effect at lower concentration than R-indobufen. However, inter-individual variation of the pharmacodynamic response was smaller in R-indobufen. The present study suggests the optimal doses of R-and S-enantioselective indobufen formulations in terms of treatment efficacy for patients with thromboembolic problems. The proposed methodology in this study can be applied to the develop novel enantio-selective drugs more efficiently.