Predictive performance of pharmacokinetic methods for phenytoin dosing: a multi-center evaluation in 282 patients with epilepsy

G. Zaccara, A. Messori, G. C. Muscas, F. Albani, A. Baruzzi, A. Bianchi, R. Riva, T. Valenza, P. Zagnoni, P. Zolo, R. Zappoli

Research output: Contribution to journalArticle

Abstract

A retrospective study was conducted in 282 patients with epilepsy to assess the predictive performance of pharmacokinetic methods for individualizing dosage of phenytoin. Two population-based dosing methods (population clearance method and bayesian feedback method) and one individual-based method (the so-called linearized Michaelis-Menten method) were evaluated, when applicable, for single-point and/or 2-point dose predictions of phenytoin. In single-point predictions, we found a generally low percentage of dose calculations falling inside the ±10% range (48.9% and 51.1% for the population clearance and the bayesian methods, respectively). In 2-point predictions, the bayesian method was 'accurate' (dose within the ±10% range) in approximately 54.3% or 55.0% of cases (depending on the particular method of implementation adopted). An even worse percentage of 'accurate' dose predictions (38.3%) was obtained by using the linearized Michaelis-Menten method. Our data do not confirm results from previous studies indicating a generally good performance of pharmacokinetic methods for predicting phenytoin dosage.

Original languageEnglish
Pages (from-to)253-261
Number of pages9
JournalEpilepsy Research
Volume3
Issue number3
DOIs
Publication statusPublished - 1989

Keywords

  • Bayesian
  • Forecasting
  • Michaelis-Menten
  • Pharmacokinetics
  • Phenytoin

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Neurology

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    Zaccara, G., Messori, A., Muscas, G. C., Albani, F., Baruzzi, A., Bianchi, A., Riva, R., Valenza, T., Zagnoni, P., Zolo, P., & Zappoli, R. (1989). Predictive performance of pharmacokinetic methods for phenytoin dosing: a multi-center evaluation in 282 patients with epilepsy. Epilepsy Research, 3(3), 253-261. https://doi.org/10.1016/0920-1211(89)90032-6