The Use of Nonlinear Mixed Effects Models in Bioequivalence Studies: A Real Data Application

Abstract

The aim of this study was to investigate the use of nonlinear mixed effects (NLME) models in a real bioequivalence study and compare it to noncompartmental analysis (NCA) which is proposed by regulatory agencies. NCA requires few hypotheses but a large number of samples per subject. On the other hand, NLME approach is more complex than NCA but it has some advantages such as it requires few samples per subject. A real data application was provided for the study, which was get from Ege University Drug Development and Pharmacokinetics Research Center. For NLME, we used the stochastic approach to expectation-maximization (SAEM) algorithm, whereas linear trapezoidal rule was used for NCA. We estimate pharmacokinetic parameters, area under the curve (AUC0-∞) and maximum concentration (Cmax), and perform a bioequivalence tests using NCA and NLME. According to real data analysis, NLME approach has smaller within subject error, narrower confidence intervals than non-compartmental analysis. However, NLME models have some limitations because of increasing type I error. Therefore, caution is needed for small sample size and data with high variability.