Population Pharmacokinetics of Pantoprazole in Patients on Dual Antiplatelet Therapy following Acute Coronary Syndrome

Abstract

Abstract Purpose Pantoprazole, a widely prescribed proton pump inhibitor, is still not fully characterized in terms of its pharmacokinetic (PK) properties. In this study, we employed nonlinear mixed-effects modeling to investigate factors influencing the variability in pantoprazole PK in patients with acute coronary syndrome undergoing dual antiplatelet therapy. Methods Blood samples were collected from 93 adult males and females receiving oral pantoprazole. Through a stepwise regression procedure various demographic and clinical covariates were tested in relation to pantoprazole concentration and elimination. These results were further substantiated by the reduction of point dispersion in goodness-of-fit plots, depicting the individual predicted versus measured concentrations, and through bootstrapping analysis. Results Pantoprazole clearance is notably influenced by C-reactive protein (CRP) levels and concurrent use of statins. Conclusion This discovery holds significant implications for tailoring pantoprazole treatment on an individual basis, providing valuable insights for optimizing therapeutic strategies in the management of patients with acute coronary syndrome, thereby maximizing therapeutic benefits.