Document Detail


Pharmacokinetic-pharmacodynamic modeling of the effect of triamcinolone acetonide on central macular thickness in patients with diabetic macular edema.
MedLine Citation:
PMID:  15452046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To develop a population model capable of describing the profile of the effect of intravitreal triamcinolone acetonide in the treatment of diabetic diffuse macular edema. METHODS: The results of 51 injections in 37 eyes (33 patients) with diffuse diabetic macular edema were studied, by using population pharmacokinetic-pharmacodynamic modeling, without triamcinolone concentration measurements. This approach was supported by the pharmacokinetic hypothesis that the intravitreal triamcinolone concentration decreases in accordance with an exponential biphasic equation. Central macular thickness (CMT), measured by optical coherence tomography was chosen as the pharmacodynamic parameter. RESULTS: The pharmacodynamic profile of the effect of triamcinolone on CMT was characterized by a curve in three phases: a fast decrease, a steady state, and a relapse. The confidence interval of most of the estimated parameters of the model was narrow. The mean estimated half-life of triamcinolone +/- SD was 15.4 +/- 1.9 days, and the mean maximum duration of its effect (+/-SD), 140 +/- 17 days. CONCLUSIONS: Pharmacokinetic-pharmacodynamic modeling using CMT constitutes a valid alternative to pharmacokinetic studies. This approach worked excellently in the present study, and the results are consistent with those published for the intraocular pharmacokinetics of triamcinolone acetonide in the human eye. The authors conclude that this type of investigation is of interest, as it avoids intraocular measurements as far as possible.
Authors:
François Audren; Michel Tod; Pascale Massin; Rym Benosman; Belkacem Haouchine; Ali Erginay; Charles Caulin; Alain Gaudric; Jean-François Bergmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  45     ISSN:  0146-0404     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-28     Completed Date:  2004-11-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3435-41     Citation Subset:  IM    
Affiliation:
Ophthalmology Department, Hôpital Lariboisière, Université Paris 7, Paris, France. francoisaudren@hotmail.com <francoisaudren@hotmail.com>
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diabetic Retinopathy / drug therapy*,  metabolism
Glucocorticoids / pharmacokinetics*,  pharmacology*
Half-Life
Humans
Injections
Macula Lutea / drug effects*,  metabolism,  pathology
Macular Edema / drug therapy*,  metabolism
Middle Aged
Models, Biological*
Time Factors
Tomography, Optical Coherence
Triamcinolone Acetonide / pharmacokinetics*,  pharmacology*
Vitreous Body
Chemical
Reg. No./Substance:
0/Glucocorticoids; 76-25-5/Triamcinolone Acetonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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