Population pharmacokinetics of oxcarbazepine: a systematic review

ABSTRACT

Introduction

Oxcarbazepine is commonly used as first-line treatment for partial and generalized tonic-clonic seizures. Owing to the high pharmacokinetic variability, several population pharmacokinetic models have been developed for oxcarbazepine to explore potential covariates that affect its pharmacokinetic variation.

Areas covered

This review summarizes the published population pharmacokinetic studies of oxcarbazepine in children and adults available in PubMed and Embase databases. The quality of the retrieved studies was evaluated, and significant covariates that may have an impact on the dosage regimen of oxcarbazepine were explored.

Expert Opinion

The pharmacokinetics of oxcarbazepine was founded to be affected by body weight and co-administration with enzyme inducers. Pediatric patients require a higher dose per kilogram than adults because children generally have a higher clearance than adults. Moreover, to maintain the target concentration, patients co-administrate with enzyme inducers need a higher dose than monotherapy due to higher clearance in those patients. Because limited information is available for exposure-response relationship, additional pharmacokinetic/pharmacodynamics investigations of oxcarbazepine need to be conducted to optimize the dosage regimen in clinical practice.

KEYWORDS:

• Epilepsy
• individualized drug therapy
• nonlinear mixed effect modeling
• oxcarbazepine
• population pharmaco-kinetic

Acknowledgments

The authors would like to sincerely thank Dr. Vincent Jullien from Service de Pharmacologie, Hôpital européen Georges Pompidou, France; Yang Wang and Jing Peng from Department of Pharmacy, Wuhan Children’s Hospital, China; Yunli Yu from Department of Clinical Pharmacology, The Second Affiliated Hospital of Soochow University, China for providing details about the research and active discussions on the coding. We would like to thank Hai-ni Wen MPharm from Shanghai Chest Hospital; and Ph.D. candidate Xiao-qin Liu from Department of Pharmacy, Huashan Hospital, Fudan University, China for their critical comments. We would also like to thank Editage (www.editage.cn) for English language editing.

Author contributions

Yue-ting Chen: Data curation, Writing- Original draft preparation, Writing- Reviewing and Editing, Visualization; Chen-yu Wang: Data curation, Writing- Reviewing and Editing; Yi-Wei Yin: Writing- Reviewing and Editing, Supervision; Zi-ran Li: Software, Writing- Reviewing and Editing; Wei-wei Lin: Software, Validation, Writing- Reviewing and Editing; Min Zhu: Software; Zheng Jiao: Conceptualization, Methodology, Writing- Reviewing and Editing, Supervision.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.