{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:17:59Z","timestamp":1760710679469,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To optimise the dosing regimen of oseltamivir for immunocompromised (IC) paediatric patients (&lt;18\u2009years) with influenza, we used an extrapolation approach alongside clinical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Efficacy was extrapolated from adult IC patients to paediatric IC patients by leveraging existing efficacy, safety, pharmacokinetic (PK)\/pharmacodynamic (PD), and disease\u2010progression models of oseltamivir and oseltamivir carboxylate (OC). Data of IC paediatric patients from two studies (NV25719 and NV20234) were included in the population PK (<jats:italic>n<\/jats:italic>\u2009=\u200930), PK\/PD analysis (<jats:italic>n<\/jats:italic>\u2009=\u200922) and disease modelling approach (<jats:italic>n<\/jats:italic>\u2009=\u200936). Simulations were performed to identify the optimal dosing regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clearance of oseltamivir (CL) and OC (CL<jats:sub>M<\/jats:sub>) were similar in IC and otherwise\u2010healthy (OwH) patients &lt;10\u00a0years, but decreased by 44.4% (95% CI: 26.8\u201362.0) and 49.1% (95% CI: 34.5\u201363.8), respectively, in IC patients aged 10\u201317\u2009years versus OwH patients. There were no notable exposure\u2013response relationships for any of the virologic PD analyses. Thus, no additional benefit was seen with oseltamivir carboxylate exposures higher than achieved with the conventional dose (75\u2009mg twice daily, age\u2010 and weight\u2010adjusted for children &lt;13\u2009years). The disease model illustrated that doses above the conventional oseltamivir dose had limited impact on viral kinetics in IC paediatric patients and a prolonged treatment duration of 10\u00a0days was favoured to limit potential viral rebound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An oseltamivir dosage recommendation (conventional dose, twice daily for 10\u00a0days) was established in IC paediatric patients with influenza, based on extrapolation of efficacy from IC adults, leveraging population PK, PK\/PD, and disease modelling, whilst taking resistance and safety data into account.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15059","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T12:37:39Z","timestamp":1630067859000},"page":"1189-1201","source":"Crossref","is-referenced-by-count":1,"title":["Dosing regimen optimisation for oseltamivir in immunocompromised paediatric patients with influenza: Extrapolation of efficacy"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7255-7495","authenticated-orcid":false,"given":"Eric Burroughs","family":"Jordie","sequence":"first","affiliation":[{"name":"Translational &amp; Systems Pharmacology Metrum Research Group LLC  Tariffville CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Gibiansky","sequence":"additional","affiliation":[{"name":"QuantPharm LLC  North Potomac MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Knab","sequence":"additional","affiliation":[{"name":"Translational &amp; Systems Pharmacology Metrum Research Group LLC  Tariffville CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annabelle","family":"Lemenuel\u2010Diot","sequence":"additional","affiliation":[{"name":"Roche Innovation Center Basel Roche Pharmaceutical Research and Early Development  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patanjali","family":"Ravva","sequence":"additional","affiliation":[{"name":"Roche Innovation Center New York Roche Pharmaceutical Research and Early Development  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elke","family":"Zwanziger","sequence":"additional","affiliation":[{"name":"Roche Innovation Center Basel Roche Pharmaceutical Research and Early Development  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastien","family":"Jolivet","sequence":"additional","affiliation":[{"name":"Roche Innovation Center Basel Roche Pharmaceutical Research and Early Development  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajinder","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Integrated Drug Development Certara Strategic Consulting  Parsippany NJ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jules","family":"Hern\u00e1ndez\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Roche Products Limited Product Development  Welwyn Garden City UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Nasmyth\u2010Miller","sequence":"additional","affiliation":[{"name":"Roche Products Limited Product Development  Welwyn Garden City UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Sturm","sequence":"additional","affiliation":[{"name":"Roche Innovation Center Basel Roche Pharmaceutical Research and Early Development  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050740"},{"key":"e_1_2_10_3_1","unstructured":"Tamiflu\u00ae US Prescribing Information.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2016\/021087s068 021246s051lbl.pdf. 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