Abstract

We address the problem of the choice and the evaluation of designs in population pharmacokinetic studies that use non-linear mixed-effects models. Criteria, based on the Fisher information matrix, have been developed to optimize designs and adapted to such models. We optimize designs under different constraints and evaluate them for a population pharmacokinetics study, within a new phase III trial of enoxaparin, a low molecular weight heparin. To do this, we approximate the expression of the Fisher information matrix for non-linear mixed-effects models including the residual error variance as a parameter to be estimated. We use the Fedorov-Wynn algorithm to minimize the inverse of the determinant of this matrix as required by the D-optimality criterion. Two optimal designs, as well as a design defined by pharmacologists, are evaluated by the simulation of 30 replicated data sets with NONMEM; all designs involve 220 patients with four measurements per patient. We also evaluate the relevance of the standard errors of estimation given from the Fisher information matrix by comparison with those given by NONMEM. The three designs provide more precise population parameter estimates; the optimal design gives the best precision and offers a simple clinical implementation. The expected standard errors given by the information matrix are close to those obtained by NONMEM on the simulation. Moreover, the proposed criterion of D-optimality appears to be a good measure to compare designs for population studies.

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