• Satoshi Shoji, Misaki Suzuki, Yoshiro Tomono, Howard N Bockbrader, and Shigeyuki Matsui.
• Clinical Pharmacology, Clinical Research, Development Japan, Pfizer Japan Inc., Shinjuku Bunka Quint Bldg 3-22-7, Yoyogi, Shibuya-ku, Tokyo 151-8589, Japan. satoshi.shoji@pfizer.com
• Br J Clin Pharmacol. 2011 Jul 1;72(1):63-76.

AimPregabalin, a chemical analogue of the mammalian neurotransmitter γ-aminobutyric acid, has been approved in many countries for partial-onset seizures, generalized anxiety disorder and various other pain disorders, including neuropathic pain associated with post-herpetic neuralgia and diabetic peripheral neuropathy and fibromyalgia. The aim of this study was to develop a population pharmacokinetic model and quantify the influence of covariates on the parameters.MethodsThis pregabalin population pharmacokinetic analysis was conducted on data from 14 clinical trials involving healthy subjects, subjects with impaired renal function and patients with post-herpetic neuralgia or diabetic peripheral neuropathy (n= 616). The data analysis was performed using nonlinear mixed effects modelling methodology as implemented by NONMEM.ResultsA one-compartment model with first-order absorption and elimination adequately described pregabalin pharmacokinetics. The model indicated that pregabalin apparent clearance (CL/F) was proportional to estimated creatinine clearance (CL(cr) ). The pregabalin systemic exposure in patients with lower renal function who received pregabalin 150 mg twice daily was almost equal to that of patients with normal renal function administered pregabalin 300 mg twice daily. The systemic exposure stratified by lower or normal renal function was similar between patients with post-herpetic neuralgia and diabetic peripheral neuropathy.ConclusionThe developed model identified CL(cr) and ideal body weight as clinically influential covariates on CL/F and volume of distribution, respectively. This study indicates that renal function accounts for variability in the apparent clearance of pregabalin which is consistent with what is known about the elimination of this drug.© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

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