Another argument in favor of using F1 ~ EXP(ETA(1)) instead of block OMEGA matrix is the covariate modeling. In cases where variability in apparent CL and V is due to the F1 variability, this formulation allows for more mechanistic interpretation of the covariate effects and ETA dependencies on covariates. For example, one can easily explain why ETA_F1 may depend on food while it is less straightforward to interpret ETA_V dependence on food. So while these models (with F1=1 and OMEGA block versus F1=EXP(ETA(1)) and diagnonal OMEGA), may be numerically similar if not equivalent, it could be better to use more mechanistically relevant model and put the variability where it would be expected from the mechanistic point of view.
Regards,
Leonid

--------------------------------------
Leonid Gibiansky, Ph.D.
President, QuantPharm LLC
web:    www.quantpharm.com
e-mail: LGibiansky at quantpharm.com
tel:    (301) 767 5566



On 11/25/2013 1:43 PM, Nick Holford wrote:
Bob,

You use an estimation method justification for choosing between
estimating the covariance of CL and V and estimating the variance of F.

An alternative view is to apply a fixed effect assumption based on
pharmacokinetic theory. The fixed effect assumption is that some of the
variation in CL and V is due to differences in bioavailability and other
factors such as linear plasma protein binding and differences in the
actual amount of drug in the oral formulation. This fixed effect
assumption is described in the model by the variance of F.

It is quite plausible to imagine that there is still some covariance
between CL and V that is not related to the differences in F. For
example, if you did not know the subject's weights and therefore could
not account for the correlated effects of weight on CL and V. The
estimation of the variance of F would only partly account for this
because of the non-linear correlation of weight with CL and V. Another
non-linear correlation would occur if plasma protein binding was
non-linear in the range of measured total concentrations.

In such case one might propose trying to estimate the covariance of CL
and V as well as including F as a fixed effect and estimating the
variance of F. Do you think that SAEM or IMP would be able to come up
with a reasonable estimate of the covariance of CL and V?

Best wishes,

Nick


On 26/11/2013 4:04 a.m., Bob Leary wrote:
Nele,
Basically what you have done is traded an off diagonal parameter in a two 
dimensional Omega matrix for an extra  on-diagonal parameter in a three 
dimensional  diagonal Omega matrix.
Y0u still have 3 Omega parameters either way.
For methods like SAEM and IMP, the two-dimensional formulation is much 
preferable since you end up in a lower 2-d dimensional eta space  which a) is 
easier to sample,
b) is easily mu-modeled (not the case for the 3-d formulation) , and c)  SAEM 
and IMP methods handle full block  Omegas  very naturally, in fact more 
naturally than
diagonal Omegas.     With FOCEI it is not so clear if there would be any 
difference at all.



-----Original Message-----
From:[email protected]  [mailto:[email protected]] On 
Behalf Of Mueller-Plock, Nele
Sent: Monday, November 25, 2013 2:05 AM
To: Leonid Gibiansky; 'nmusers'
Subject: RE: [NMusers] Getting rid of correlation issues between CL and volume 
parameters

Dear Leonid,

Thanks for your answer. Maybe I was not completely clear about the reasons why 
I tried to account for F1. The reason is that after oral dosing, a correlation 
between CL and should be present, as these parameters in reality represent CL/F 
and V/F. One way to account for this would be to estimate the correlation via 
the $OMEGA BLOCK syntax. As this is sometimes hard to estimate, I looked if any 
alternative is available, and then found the discussion of this topic in the 
provided link (http://www.wright-dose.com/tip2.php).
>From your answer, I would conclude that the proposed code should only account 
for random between-subject variability, i.e. it should only consider the ETA on 
F1, but not the THETA (which in my example had values of 1, 0.8 and 0.5). Is this 
correct?

So whereas an increase in ETA on F1 without accounting for the correlation 
would automatically result in positive ETA values for CL and V, even without 
any inherent variability in true CL and V, with the code

F1=1
FF1=EXP(ETA(1))
CL=THETA()*EXP(ETA())/FF1
V=THETA()*EXP(ETA())/FF1

this would already be taken care of, and the $OMEGA BLOCK could be omitted. 
Right?

Thanks and best
Nele
______________________________________________________________

Dr. Nele Mueller-Plock, CAPM
Principal Scientist Modeling and Simulation Global Pharmacometrics Therapeutic 
Area Group

Takeda Pharmaceuticals International GmbH Thurgauerstrasse 130
8152 Glattpark-Opfikon (Zürich)
Switzerland

Visitor address:
Alpenstrasse 3
8152 Glattpark-Opfikon (Zürich)
Switzerland

Phone: (+41) 44 / 55 51 404
Mobile: (+41) 79 / 654 33 99

mailto:[email protected]
http://www.takeda.com

-----Original Message-----
From: Leonid Gibiansky [mailto:[email protected]]
Sent: Freitag, 22. November 2013 19:44
To: Mueller-Plock, Nele; 'nmusers'
Subject: Re: [NMusers] Getting rid of correlation issues between CL and volume 
parameters

Nele,
I am not sure why would you like to divide by F1.
Can we just do it explicitly?

F1=EXP(ETA(1))
(or F1=function(dose)*EXP(ETA(1))
CL=..
V=..

F1 can be > 1 as it is not absolute but relative (to the other subjects); I 
assume that this is oral dose, not IV, correct?

In your code, be careful not to call it F1 as the nonmem will interpret it as 
bioavailability parameter, and you should not account for it twice.

So it should be either
F1=EXP(ETA(1))
CL=THETA()*EXP(ETA())
V=THETA()*EXP(ETA())

or

F1=1 (can me implicit and omitted)
FF1=EXP(ETA(1))
CL=THETA()*EXP(ETA())/FF1
V=THETA()*EXP(ETA())/FF1

but not

F1=EXP(ETA(1))
CL=THETA()*EXP(ETA())/F1
V=THETA()*EXP(ETA())/F1

Leonid




--------------------------------------
Leonid Gibiansky, Ph.D.
President, QuantPharm LLC
web:www.quantpharm.com
e-mail: LGibiansky at quantpharm.com
tel:    (301) 767 5566



On 11/22/2013 12:14 PM, Mueller-Plock, Nele wrote:
Dear all,

I have come across an interesting proposal to account for correlation between 
CL and volume parameters by dividing by bioavailability within the NONMEM 
control stream:

http://www.wright-dose.com/tip2.php

I liked the approach, however I have been wondering how exactly to interpret 
the resulting parameter values for CL and V.

As an illustration, a potential problem might be that we have doses of 10, 25 
and 50 mg with a fixed bioavailability of 100% for the 10 mg dose, and 
bioavailabilities of 80% and 50% for the doses of 25 and 50 mg, respectively. 
In addition, a between-subject variability on F1 of ~30% would be present.

If I now code my CL and V as follows:
CL=THETA(1)/F1
V=THETA(2)/F1,
to account for the correlation between CL and V, what exactly would be the 
meaning/interpretation of THETA(1) and THETA(2)?
As the THETAs would be the same for all doses, the CL of 50 mg would be twice 
as high as the one for the 10 mg dose – does that make sense, as we already 
estimated the reduced relative bioavailability using parameter F1?

Any comments would be very much appreciated.
Thanks and best
Nele



Dr. Nele Müller-Plock, CAPM
Principal Scientist Modeling and Simulation Pharmacometrics
Experimental Medicine

Takeda Pharmaceuticals International GmbH
8152 Glattpark-Opfikon (Zürich)
Switzerland

Visitor address:
Alpenstrasse 3
8152 Glattpark-Opfikon (Zürich)
Switzerland

Phone: (+41) 44 / 55 51 404
Mobile: (+41) 79 / 654 33 99
mailto:[email protected]
http://www.takeda.com
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University of Auckland,85 Park Rd,Private Bag 92019,Auckland,New Zealand
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Holford NHG. Disease progression and neuroscience. Journal of Pharmacokinetics 
and Pharmacodynamics. 
2013;40:369-76http://link.springer.com/article/10.1007/s10928-013-9316-2
Holford N, Heo Y-A, Anderson B. A pharmacokinetic standard for babies and 
adults. J Pharm Sci. 
2013:http://onlinelibrary.wiley.com/doi/10.1002/jps.23574/abstract
Holford N. A time to event tutorial for pharmacometricians. CPT:PSP. 
2013;2:http://www.nature.com/psp/journal/v2/n5/full/psp201318a.html
Holford NHG. Clinical pharmacology = disease progression + drug action. British 
Journal of Clinical Pharmacology. 
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