Population pharmacokinetic-pharmacodynamic model of subcutaneous
bupivacaine in a novel extended-release microparticle formulation
Abstract
The objective of this study was to develop a population
pharmacokinetic-pharmacodynamic model of subcutaneously administered
bupivacaine in a novel extended release microparticle formulation for
postoperative pain management. Bupivacaine was administered
subcutaneously in the lower leg to 28 healthy male subjects in doses
from 150 to 600 mg in a phase 1 randomized, placebo-controlled,
double-blind, dose-ascending study with two different compositions of
microparticle formulations called LIQ865. Population
pharmacokinetic-pharmacodynamic models were fitted to plasma
concentration-effect-time data using non-linear mixed-effects modeling.
The pharmacokinetics were best described by a two-compartment model with
biphasic absorption as two parallel absorption processes: a fast,
zero-order process and a slower, first-order process with two transit
compartments. The slow absorption process was found to be dose-dependent
and rate-limiting for bupivacaine clearance at higher doses. Bupivacaine
clearance and the transit rate constant describing the slow absorption
process both decreased with increasing doses following a power function
with a shared covariate effect of dose on the two parameters. The
pharmacokinetic-pharmacodynamic relationship between plasma
concentrations and effect was best described by a linear function. This
model gives new insight into the pharmacokinetics and pharmacodynamics
of microparticle formulations of bupivacaine, and the biphasic
absorption seen for several local anesthetics.