System and method for providing patient-specific dosing as a function of mathematical models updated to account for an observed patient response
A system and method for predicting, proposing and/or evaluating suitable medication dosing regimens for a specific individual as a function of individual-specific characteristics and observed responses of the specific individual. Mathematical models of observed patient responses are used in determining an initial dose. The system and method use the patient's observed response to the initial dose to refine the model for use to forecast expected responses to proposed dosing regimens more accurately for a specific patient. More specifically, the system and method uses Bayesian averaging, Bayesian updating and Bayesian forecasting techniques to develop patient-specific dosing regimens as a function of not only generic mathematical models and patient-specific characteristics accounted for in the models as covariate patient factors, but also observed patient-specific responses that are not accounted for within the models themselves, and that reflect variability that distinguishes the specific patient from the typical patient reflected by the model.
1. A pharmaceutical formulation for administration to a subject patient in a dosing regimen determined by Bayesian model analysis, the pharmaceutical formulation comprising:
an active ingredient in a first modified dose having a per-unit quantity,
wherein the Bayesian model analysis determines the first modified dose, the Bayesian model analysis comprising the steps of:
receiving (i) administered dose data comprising an initial per-unit quantity of the active ingredient administered to the patient in an initial dosing regimen; (ii) a first plurality of characteristics associated specifically with the subject patient and the initial per-unit quantity of the active ingredient, wherein the first plurality of characteristics comprises a response of the subject patient to the initial dosing regimen; and (iii) a plurality of proposed doses of the active ingredient;
accessing a memory;
selecting, based on at least a portion of the first plurality of characteristics, a first model from a plurality of models stored in the memory; and
calculating, based on the first model and the first plurality of characteristics, the dosing regimen, the dosing regimen comprises the first modified dose, wherein the first modified dose is selected based on testing the plurality of proposed doses to predict a response by the patient to each of the proposed doses.
2. The pharmaceutical formulation of claim 1 , wherein the Bayesian model analysis includes a Bayesian model averaging analysis based on at least two models for the active ingredient.
3. The pharmaceutical formulation of claim 2 , wherein the initial dose is a per-unit quantity of the active ingredient administered to the patient in an initial dosing regimen prior to administration of the first modified dose.
4. The pharmaceutical formulation of claim 1 , wherein the response includes a physiological measurement or assessment of the subject patient made after administration of the initial dosing regimen.
5. The pharmaceutical formulation of claim 4 , wherein the response is measurable.
6. The pharmaceutical formulation of claim 5 wherein the measurement or assessment includes a lab result associated with the patient.
7. The pharmaceutical formulation of claim 6 , wherein the measurement or assessment includes determining a concentration of the active ingredient in a sample taken from the subject patient.
8. The pharmaceutical formulation of claim 7 , wherein the measurement or assessment further includes at least one of weight, gender, race, prior therapy, and disease stage or severity.
9. The pharmaceutical formulation of claim 7 , wherein the active ingredient is Infliximab.
10. The pharmaceutical formulation of claim 9 , wherein at least one of the first plurality of characteristics includes a trough concentration of Infliximab, and wherein the trough concentration is below a target level concentration.
11. The pharmaceutical formulation of claim 9 , wherein the first modified dose has at least one of a different per unit quantity, different delivery interval, and different input duration than the initial dose.
12. The pharmaceutical formulation of claim 9 , wherein the first modified dose has a longer input duration than the initial dose.
13. The pharmaceutical formulation of claim 12 , wherein the first modified dose is lower in per-unit quantity than the initial dose.
14. The pharmaceutical formulation of claim 12 , wherein the first modified dose has a shorter delivery interval than the initial dose.
15. The pharmaceutical formulation of claim 12 , wherein the first modified dose has a lower per-unit quantity than the initial dose and a shorter delivery interval than the initial dose.
16. The pharmaceutical formulation of claim 12 , wherein the first modified dose has a higher per-unit quantity than the initial dose and a shorter delivery interval than the initial dose.
17. The pharmaceutical formulation of claim 12 , wherein total administered dose over duration of treatment is lower for the first modified dose than for the initial dose.
18. The pharmaceutical formulation of claim 12 , wherein total administered dose over duration of treatment is substantially the same for the first modified dose and the initial dose, but the first modified dose has at least one of a different delivery interval than the initial dose and a different input duration than the initial dose.
19. The pharmaceutical formulation of claim 4 , comprising the active ingredient in a second modified dose having a second per unit quantity, the second modified dose being determined by a Bayesian model averaging analysis that incorporates the initial dose, the first plurality of characteristics, the first modified dose, and a second plurality of characteristics of the subject patient that are measured or assessed after administration of the first modified dose.
20. The pharmaceutical formulation of claim 19 , wherein the second plurality of physical characteristics include concentration of a component in a sample taken from blood of the subject patient after receipt of the first modified dose.
21. The pharmaceutical formulation of claim 20 , wherein the active ingredient is Infliximab.
22. The pharmaceutical formulation of claim 21 , wherein the first dose is determined based on a composite model that incorporates an observed second response and an expected second response by the subject patient to the initial dose.
23. The pharmaceutical formulation of claim 22 , wherein the composite model is applied in a Bayesian update analysis that incorporates the observed second response.
24. The pharmaceutical formulation of claim 4 , wherein the first dose is determined based on a composite model that incorporates observed responses and an expected response by the subject patient to the initial dose.
25. The pharmaceutical formulation of claim 24 , wherein the composite model is applied in a Bayesian update analysis that incorporates at least one observed response.
26. The pharmaceutical formulation of claim 4 , wherein the first dose is determined based on a Bayesian model average, Bayesian update and Bayesian forecast.
27. The pharmaceutical formulation of claim 1 , wherein the first plurality of characteristics includes medication concentration data measured from the patient.
28. The pharmaceutical formulation of claim 1 , wherein the Bayesian model analysis further comprises the step of updating the selected first model, based on the response of the subject patient to the initial dosing regimen.
29. The pharmaceutical formulation of claim 1 , wherein the first modified dose comprises a first dosing amount, a first dose interval, and a first route of administration.
30. The pharmaceutical formulation of claim 1 , wherein the first modified dose is calculated to achieve a therapeutic goal for the subject patient.