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Matthew M Hutmacher

Publications and source records attributed to Matthew M Hutmacher.

3 recordsLinked to original sources

Collapsing mechanistic models: an application to dose selection for proof of concept of a selective irreversible antagonist.

When data fail to support fully mechanistic models, alternative modeling strategies must be pursued. Simpler, more empirical models or the fixing of various rate constants are necessary to avoid over-parameterization. Fitting empirical models can dilute information, limit interpretation, and cloud inference. Fixing rate constants requires external, relevant, and reliable information on the mechanism and can introduce subjectivity as well as complicate determining the validity of model extrapolation. Furthermore, both these methods ignore the possibility that failure of the data to support the mechanistic model could contain information about the pharmacodynamic process. If the pathway has processes with "fast" dynamics, these steps could collapse yielding parametrically simpler classes of models. The collapsed models would retain the mechanistic interpretation of the full model, which is crucial for performing substantive inference, while reducing the number of parameters to be estimated. These concepts are illustrated through their manifestations on the dose-effect relationship and ensuing dose selection for a proof of concept study. Specifically, a mechanistic model for a selective irreversible antagonist was posited and candidate classes of models were derived utilizing "fast dynamics" assumptions. Model assessment determined the rate-limiting step facilitating pertinent inference with respect to the mechanism. For comparison, inference using a more empirical modeling strategy is also presented. A general solution for the collapse of the typical PK-PD model differential equations is provided in Appendix A.

Administration, Oral↗

A method of obtaining starting values of k(in) and k(out) for the indirect response models.

A method based on the multivariate technique known as principal component analysis is proposed to obtain starting values for the rate constants of indirect response models. The method is not iterative and only requires standard deviation calculations for two quantities, which are simple functions of the measured pharmacodynamic response. An algorithm is provided which can be implemented in a spreadsheet. The methodology is justified theoretically herein, nevertheless, two examples are provided to illustrate the method and demonstrate its viability.

Algorithms↗

A two-part mixture model for longitudinal adverse event severity data.

We fit a mixed effects logistic regression model to longitudinal adverse event (AE) severity data (four-point ordered categorical response) to describe the dose-AE severity response for an investigational drug. The distribution of the predicted interindividual random effects (Bayes predictions) was extremely bimodal. This extreme bimodality indicated that biased parameter estimates and poor predictive performance were likely. The distribution's primary mode was composed of patients that did not experience an AE. Moreover, the Bayes predictions of these non-AE patients were nearly degenerative, i.e., the predictions were nearly identical. To resolve this extreme bimodality we propose using a two-part mixture modeling approach. The first part models the incidence of AE's, and the second part models the severity grade given the patient had an AE. Unconditional probability predictions are calculated by mixing the incidence and severity model probability predictions. We also report results of simulation studies, which assess the predictive and statistical (bias and precision) performance of our approach.

Bayes Theorem↗