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Mathematical modelling of gene delivery in patients with haemophilia B

Jamili, Elnaz; Nathwani, Amit C; Dua, Vivek; (2023) Mathematical modelling of gene delivery in patients with haemophilia B. Chemical Engineering Science , 281 , Article 119073. 10.1016/j.ces.2023.119073. Green open access

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Abstract

Type B haemophilia is a bleeding disorder resulting from a deficiency of coagulation factor IX (FIX). Although gene therapy is a potentially curative treatment option, optimising the dosing of therapeutic genes for patients remains a challenge. Detailed simulation of gene delivery systems is required for improved understanding of the system. Hence, the purpose of this paper is to develop a modelling framework to predict the physiological response of a subject affected by type B haemophilia to a dose of vector. To address this, an integrated pharmacokinetic/pharmacodynamic (PK/PD) modelling platform was developed based on in vivo clinical data for three patients with severe haemophilia B whose functional plasma levels of FIX are less than 1% of the normal value. The plasma FIX activity was considered as the pharmacological effect while the level of serum alanine aminotransferase (ALT) demonstrated the hepatocellular toxicity. Both an individual-based modelling approach and a population modelling approach were used to estimate the physiological parameters of the developed PK/PD models. The models were then validated using data of the clinical study before being used in a simulation-based modelling approach to provide dosing recommendations. The results obtained from the study demonstrate a good prediction of the pharmacokinetics and pharmacodynamics of the vector. Model-based simulations were subsequently performed to guide initial dose selection in order to provide clinicians with better tools to make the decision-making process simpler for designing more effective treatment plans.

Type: Article
Title: Mathematical modelling of gene delivery in patients with haemophilia B
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ces.2023.119073
Publisher version: https://doi.org/10.1016/j.ces.2023.119073
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Gene delivery, Initial dose selection, Pharmacokinetic/pharmacodynamic modelling, Toxicity, Efficacy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Chemical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/10174097
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