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M94B0811.TXT
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1994-11-11
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Document 0811
DOCN M94B0811
TI Effect of 2',3'-didehydro-3'-deoxythymidine in an in vitro hollow-fiber
pharmacodynamic model system correlates with results of dose-ranging
clinical studies.
DT 9412
AU Bilello JA; Bauer G; Dudley MN; Cole GA; Drusano GL; Department of
Medicine, Albany Medical College, New York 12208.
SO Antimicrob Agents Chemother. 1994 Jun;38(6):1386-91. Unique Identifier :
AIDSLINE MED/94379796
AB We sought to validate an in vitro system which could predict the minimal
effect dose of antiretroviral agents. Mixtures of uninfected CEM cells
and CEM cells chronically infected with human immunodeficiency virus
(HIV) type 1 MN were exposed to 2',3'-didehydro-3'-deoxythymidine (D4T)
in vitro in a hollow-fiber model which simulates the plasma
concentration-time profile of D4T in patients. Drug concentration was
adjusted to simulate continuous intravenous infusion, or an intravenous
bolus administered twice daily. The effect of the dosing regimen was
measured with viral infectivity, p24 antigen, and reverse transcriptase
or PCR for unintegrated HIV DNA. Dose deescalation studies on a
twice-daily dosing schedule predicted a minimum effect dose of 0.5 mg/kg
of body weight per day which correlated with the results of a clinical
trial. Antiviral effect was demonstrated to be independent of schedule
for every 12-h dosing versus continuous infusion. Finally, at or near
the minimal effect dose, efficacy appeared to depend on the viral load.
The ability of this in vitro pharmacodynamic model to assess the
response of HIV-infected cells to different doses and schedules of
antiviral agents may be useful in the design of optimal dosing regimens
for clinical trials but requires validation with other types of
antiretroviral agents.
DE Cell Line Dose-Response Relationship, Drug DNA, Viral/ANALYSIS Human
HIV/*DRUG EFFECTS/GENETICS/PHYSIOLOGY Models, Biological
Stavudine/ADMINISTRATION & DOSAGE/*PHARMACOLOGY/PHARMACOKINETICS
Support, Non-U.S. Gov't Virus Replication/DRUG EFFECTS JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).