Webinar recap
This installment of the All Welcome Webinar Series made the clinical case for model-informed precision dosing, starting with why standard doses so often miss for drugs with narrow therapeutic windows and wide variability between patients.
The presentation built the method from first principles. Population pharmacokinetic models describe how a drug behaves across patients, and Bayesian estimation combines that prior knowledge with an individual’s measured concentrations to choose the dose most likely to reach target. Patient cases with voriconazole, amprenavir, and vancomycin showed the approach resolving dosing questions that repeated trial-and-error adjustments had not.
The evidence centered on a prospective vancomycin trial comparing trough-guided dosing with Bayesian AUC-guided dosing. Seventy percent of AUC measurements were in the therapeutic range, compared with 19% of troughs, and nephrotoxicity fell from 7% of patients in the trough-guided year to 0% and 2% in the two Bayesian years. Prospective studies of tacrolimus and busulfan showed similar gains, with more patients reaching target from fewer samples.
