@article{fdi:010063967,
  title = {{I}mpact of body weight and missed doses on lopinavir concentrations with standard and increased lopinavir/ritonavir doses during late pregnancy},
  author = {{C}ressey, {T}. {R}. and {U}rien, {S}. and {C}apparelli, {E}. {V}. and {B}est, {B}. {M}. and {B}uranabanjasatean, {S}. and {L}imtrakul, {A}. and {R}awangban, {B}. and {S}absanong, {P}. and {T}reluyer, {J}. {M}. and {J}ourdain, {G}onzague and {S}tek, {A}. and {L}allemant, {M}arc and {M}irochnick, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives: {T}o assess the influence of body weight and missed doses on lopinavir pharmacokinetics with standard and increased doses of lopinavir/ritonavir melt extrusion tablets during late pregnancy. {P}atients and methods: {L}opinavir concentration data during the third trimester of pregnancy were pooled from clinical trials in {T}hailand ({NCT}00409591) and the {USA} ({NCT}00042289). {A} total of 154 {HIV}-infected pregnant women receiving either 400/100 mg (standard) or 600/150 mg (increased) twice daily had lopinavir plasma concentration data available. {P}opulation parameters were estimated using non-linear mixed-effects regression models. {M}onte {C}arlo simulations were performed to estimate the probability of achieving target lopinavir trough concentrations (>1.0 mg/{L}) with standard and increased doses of lopinavir/ritonavir during pregnancy. {R}esults: {T}he median (range) age, weight and gestational age were 28 years (18-43), 62 kg (45-123) and 33 weeks (29-38), respectively. {B}ody weight influenced lopinavir oral clearance ({CL}/{F}) and volume of distribution ({V}/{F}). {P}opulation estimates of lopinavir {CL}/{F} and {V}/{F} were 6.21 {L}/h/70 kg and 52.6 {L}/70 kg, respectively. {B}ased on simulations, the highest risk of subtherapeutic trough concentrations was for women weighing >100 kg using the standard dose (similar to 7%), while the risk was,2% with the 600/150 mg dose for women weighing 40-130 kg. {A}fter a missed dose, 61% of women have lopinavir concentrations below target prior to the next dose with the standard dose compared with 42% with the increased dose. {C}onclusions: {S}tandard dosing provides adequate lopinavir trough concentrations for the majority of pregnant women but increased doses may be preferable for women weighing. 100 kg and with a history of lopinavir/ritonavir use and/or adherence issues.},
  keywords = {{HIV} ; pharmacokinetics ; {T}hailand ; {USA} ; {THAILANDE} ; {ETATS} {UNIS}},
  booktitle = {},
  journal = {{J}ournal of {A}ntimicrobial {C}hemotherapy},
  volume = {70},
  numero = {1},
  pages = {217--224},
  ISSN = {0305-7453},
  year = {2015},
  DOI = {10.1093/jac/dku367},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063967},
}