# Integrated models of population pharmacokinetics and exposure response to optimize dosage regimen for anaprazole sodium in duodenal ulcer

## TL;DR

This study uses integrated pharmacokinetic and exposure-response models to determine the optimal dosage of anaprazole sodium for treating duodenal ulcers.

## Contribution

The integration of population pharmacokinetics and exposure-response models provides a novel approach to optimize dosing regimens for anaprazole sodium.

## Key findings

- Age significantly affects the elimination rate of the metabolite M21-1.
- Anaprazole sodium shows a high healing rate (94.0%) in duodenal ulcer patients.
- Dosage between 20 and 100 mg once daily is safe and effective.

## Abstract

Anaprazole sodium enteric-coated tablet is a novel proton pump inhibitor which has been approved for the treatment of duodenal ulcer. The aim of this study is to provide reliable information for the design of an optimal dosage regimen. Population pharmacokinetics and exposure-response models were integrated to evaluate the pharmacokinetic parameters and covariates of Anaprazole and its metabolite M21-1, and subsequently provided dosage suggestions based on clinical trials and simulation data. A pharmacokinetic model incorporating two-compartment for the parent drug and one-compartment for the metabolite, with both first-order and zero-order mixed absorption was used to describe the pharmacokinetics of Anaprazole and M21-1. Age emerged as a significant covariate affecting the elimination rate constant of M21-1, with clearance decreasing as age advances. No correlation was observed between the pharmacokinetics of Anaprazole or M21-1 and the adverse reactions under the current dosages. BMI might be the influence factor of the mild gastrointestinal adverse reactions. Meanwhile, Anaprazole had a good healing rate (94.0 %) in duodenal ulcer patients and the exposure-response analysis indicated that the cured results were not influenced by the exposure parameters of parent drug or metabolite. In conclusion, the drug is safe when dosing between 20 and 100 mg once a day.

Image, graphical abstract