Table 2. Population parameter estimates from the final lumefantrine pharmacokinetic model.
Parameter | Fixed effects | Random effects | ||
---|---|---|---|---|
Population estimate (BS estimate) | %RSE (95% CI) | %CV for IIV (BS estimate) | %RSE (95% CI) | |
F | 1 (fixed) | — | 70.3 (70.2) | 5.95 (65.3–75.3) |
Box–Cox shape parameter on F | −0.343 (−0.342) | 19.5 (−0.469 to 0.215) | — | — |
ka (h−1) | 0.0386 (0.0388) | 2.72 (0.0368 to 0.0410) | — | — |
CL/F (l/h) | 1.35 (1.36) | 29.7 (0.538 to 2.19) | — | — |
VC/F (l) | 11.2 (11.6) | 30.3 (4.65 to 18.8) | 144 (141) | 10.8 (115–165) |
Q/F (l/h) | 0.344 (0.350) | 29.8 (0.137 to 0.566) | — | — |
VP/F (l) | 59.0 (59.5) | 29.7 (23.6 to 96.4) | — | — |
Dose50 (mg/kg) on F | 3.86 (4.07) | 41.5 (1.25 to 8.04) | — | — |
Pregnancy on ka | 0.352 (0.355) | 21.2 (0.212 to 0.510) | — | — |
Parasitaemia on F | −0.643 (−0.635) | 13.0 (−0.793 to 0.473) | — | — |
σ | 0.323 (0.323) | 4.88 (0.293 to 0.357) | — | — |
Coefficient of variation (%CV) for inter-individual variability (IIV) was calculated as . The relative standard error (%RSE) was calculated as from 1,000 iterations of a non-parametric bootstrap (BS) procedure. The 95% confidence interval (95% CI) is displayed as the 2.5th to 97.5th percentile of the BS estimate, and the BS estimate as the average value.
F: relative bioavailability; Box–Cox shape parameter: shape parameter on Box–Cox transformation; ka: absorption rate constant; CL/F: elimination clearance; VC/F: apparent central volume of distribution; Q/F: inter-compartmental clearance; VP/F: apparent peripheral volume of distribution; dose50: dose (mg/kg) needed for half of maximum dose-dependent saturation of F; pregnancy: categorical covariate effect of pregnancy on ka; parasitaemia: continuous covariate effect of enrolment parasite density on F; and σ: additive residual error on log scale. All parameters were centred on a non-pregnant patient weighing 42 kg with an admission parasitaemia of 15,800 parasites/μl.
Clearance and volume parameters were centred on the median body weight (WT) and scaled allometrically (); dose-dependent absorption was implemented as a saturation model (); baseline parasitaemia was implemented as an exponential relationship centred on the median natural logarithm transformed value (), and the categorical pregnancy effect was implemented as a proportional effect (ka = θ(n) × (1 + θpregnancy)).