No description available.

Progress in individualized drug treatment is of increasing importance, promising to avoid much human suffering and reducing medical treatment costs for society. The strategy is to maximize the therapeutic effects and minimize the negative side effects of a drug on individual or group basis. To reach the goal, interactions between the human body and different drugs must be further clarified, for instance by using mathematical models. Whether clinical studies or laboratory experiments are used as primary sources of information, greatly influences the possibilities of obtaining data. This must be considered both prior and during model development and different strategies must be used. The character of the data may also restrict the level of complexity for the models, thus limiting their usage as tools for individualized treatment. In this thesis work two case studies have been made, each with the aim to develop a model for a specific human-drug interaction. The first case study concerns treatment of inflammatory bowel disease with thiopurines, whereas the second is about treatment of ovarian cancer with paclitaxel. Although both case studies make use of similar amounts of experimental data, model development depends considerably on prior knowledge about the systems, the character of the data and the choice of modelling tools. All these factors are presented for each of the case studies along with current results. Further, a system for classifying different but related models is also proposed with the intention that an increased understanding will contribute to advancement in individualized drug dosage. / <p>Report code: LiU-Tek-Lic-2007:41.</p>

No description available.

Malgré les progrès évidents sur la compréhension de la carcinogénèse, l’incidence des cancers est toujours en augmentation. C’est pourquoi les besoins en nouveaux traitements sont importants. Notre travail de thèse a porté sur l’évaluation pharmacologique d’une nouvelle molécule anticancéreuse, l’OTX015. Cette petite molécule de synthèse a la propriété d’inhiber les protéines bromodomaines (famille des BET) qui jouent un rôle clé dans les mécanismes épigénétiques et dont la dérégulation favorise l’apparition de cancers en particulier des hémopathies malignes. Des études précliniques in vitro sur plusieurs lignées cellulaires d’hémopathies malignes et in vivo sur des souris xénogreffées ont permis de mettre en évidence les propriétés antitumorales de l’OTX015. Une méthode de dosage des concentrations plasmatiques d’OTX015 par UPLC-MS/MS a été développée et validée afin d’évaluer sa pharmacocinétique chez les patients inclus dans un protocole d’escalade de doses de phase I. Dans un premier temps, la PK de l’OTX015 a été modélisée par une approche de population et dans un second temps un modèle PK-PD a été construit pour pouvoir évaluer le profil de la tolérance (nombreuses thrombopénies) de cette nouvelle molécule. / Despite obvious progress in carcinogenesis understanding, the incidence of cancer is still increasing. Therefore, the need of new treatments remains important. Our thesis focused on the pharmacological evaluation of a new anticancer drug, OTX015. This small synthetic molecule inhibits the bromodomain proteins (BET) that play a key role in epigenetic mechanisms. Downregulation of BRDs promotes cancer occurrence including hematological malignancies. Preclinical evidences obtained from in vitro and in vivo studies in xenograft mice, suggest that OTX015 has antitumor properties. An ultra-performance liquid chromatography with tandem mass spectrometry detection method was developed and validated in order to measure OTX015 plasma concentrations. Its pharmacokinetics in patients enrolled in a phase I dose-escalation study was then evaluated. The OTX015 PK parameters were estimated by a population approach and PK-PD modeling was developed in order to evaluate the tolerance and safety (thrombocytopenia) of this new drug.

Atualmente a cucurbitacina E é considerada uma candidata a fármaco em razão de sua atividade anticâncer, reconhecimento de seus alvos moleculares e sinergismo com outros fármacos utilizados no tratamento do câncer. Porém, ainda não é possível seu uso na clínica devido a importantes lacunas na literatura relativas a ensaios de farmacocinética pré-clínicos e clínicos. A cucurbitacina E é hidrolisada a cucurbitacina I em plasma e em microssomas de fígado humano. O presente estudo visa avaliar a farmacocinética populacional e ligação as proteínas plasmáticas da cucurbitacina E e seu metabólito cucurbitacina I em plasma de ratos. O método de análise sequencial da cucurbitacina E e cucurbitacina I em plasma de ratos foi desenvolvido utilizando LCMS/ MS. Alíquotas de 50 ?L de plasma foram desproteinizadas com acetonitrila e os resíduos reconstituídos com acetonitrila:água (1:1, v/v) e adicionados do padrão interno clobazam. Os extratos foram injetados na coluna RP-18 com fase móvel constituída por mistura de acetonitrila:água:metanol (32:35:33, v/v/v). O método é preciso e exato com linearidade no intervalo de 1-100 ng de cucurbitacina E/mL de plasma e de 0,4-200 ng de cucurbitacina I/mL de plasma. O método foi aplicado na avaliação da farmacocinética da cucurbitacina E administrada a ratos machos Wistar em dose única oral (gavagem) e intravenosa de 1mg/kg dissolvida em DMSO e tampão fosfato salino pH 7,4 (5:95, v/v). As amostras seriadas de sangue foram coletadas até 24 h após a administração oral ou intravenosa. As concentrações plasmáticas de cucurbitacina E foram quantificadas até 16 h somente após a administração intravenosa, enquanto as concentrações plasmáticas de cucurbitacina I permaneceram abaixo dos valores de LIQ seguindo a administração oral ou intravenosa. O modelo de farmacocinética populacional foi desenvolvido para a cucurbitacina E administrada por via intravenosa com o auxílio do programa NONMEM com adequada qualidade de ajuste e desempenho preditivo. O perfil farmacocinético da cucurbitacina E administrada por via intravenosa foi descrito por modelo bicompartimental com distribuição e eliminação de primeira ordem com os seguintes parâmetros farmacocinéticos: tempo de liberação (D) de 0,45 h, volume de distribuição (Vd) de 27,22 L, clearance (Cl) de 4,13 L/h e meiavida de eliminação (t1/2) de 4,57 h. As interações da cucurbitacina E e cucurbitacina I com as albuminas séricas humana (HSA) e de rato (RSA) foram investigadas utilizando biossensor óptico baseado em ressonância de plasma de superfície (SPR) e espectroscopia de dicroísmo circular (CD). Os dados de ligação das cucurbitacinas a albuminas foram obtidos por experimentos de competição de CD com biliverdina. Os dados de SPR revelaram um evento de ligação inédito entre a cucurbitacina I e a HSA e as afinidades de ligação da cucurbitacina E e cucurbitacina I são maiores para a RSA do que para a HSA. A cucurbitacina E e a cucurbitacina I podem ser classificadas como substâncias de alta afinidade de ligação com a HSA e com a RSA. A análise de CD mostrou que a cucurbitacina E e a cucurbitacina I modificam a ligação da biliverdina as albuminas através de modulação alostérica oposta (positiva para HSA, negativa para RSA), confirmando a necessidade de cuidados na extrapolação de dados farmacocinéticos pré-clínicos para clínicos. / Cucurbitacin E is currently considered a drug candidate due to its anticancer activity, recognition of its molecular targets, and synergism with other drugs used for cancer treatment. However, the use of cucurbitacin E in clinical practice is not possible because of important research gaps regarding its preclinical and clinical pharmacokinetic characteristics. Cucurbitacin E is hydrolyzed to cucurbitacin I in plasma and in human liver microsomes. The aim of this study was to evaluate the population pharmacokinetics and plasma protein binding of cucurbitacin E and of its metabolite cucurbitacin I in rats. The method for the sequential analysis of cucurbitacins E and I in rat plasma was developed using LC-MS/MS. Plasma aliquots of 50 ?L were deproteinized with acetonitrile, the residues were reconstituted in acetonitrile:water (1:1, v/v), and clobazam was added as internal standard. The extracts were injected into an RP-18 column using a mobile phase consisting of a mixture of acetonitrile:water:methanol (32:35:33, v/v/v). The method was precise and accurate, showing linearities at a range of 1-100 ng cucurbitacin E/mL plasma and of 0.4-200 ng cucurbitacin I/mL plasma. The method was applied to the pharmacokinetic evaluation of cucurbitacin E administered to male Wistar rats at a single oral (gavage) or intravenous dose of 1 mg/kg dissolved in DMSO and phosphate-buffered saline, pH 7.4 (5:95, v/v). Serial blood samples were collected up to 24 h after oral or intravenous administration. The plasma concentrations of cucurbitacin E were quantified up to 16 h only after intravenous administration, while the plasma concentrations of cucurbitacin I remained below the limit of quantification after oral or intravenous administration. The population pharmacokinetic model was developed for administered intravenously cucurbitacin E using the NONMEM program, with adequate goodness of fit and predictive performance. The pharmacokinetic profile of intravenously administered cucurbitacin E was described by a two-compartment model with first-order distribution and elimination. The following pharmacokinetic parameters were obtained: release time (D) of 0.45 h, volume of distribution (Vd) of 27.22 L, clearance (Cl) of 4.13 L/h, and elimination half-life (t1/2) of 4.57 h. The interactions of cucurbitacin E and I with human (HSA) and rat (RSA) serum albumins were investigated using an optical biosensor by surface plasmon resonance (SPR) and circular dichroism (CD) spectroscopy. The binding data of the cucurbitacins to albumins were obtained by CD competition experiments with biliverdin. The SPR data revealed an undescribed binding event between cucurbitacin I and HSA and the binding affinities of cucurbitacin E and cucurbitacin I were higher for RSA than for HSA. Cucurbitacin E and cucurbitacin I can be classified as substances with high binding affinity for HSA and RSA. CD analysis showed that cucurbitacin E and cucurbitacin I modify the binding of biliverdin to albumins through opposite allosteric modulation (positive for HSA, negative for RSA), confirming that care should be taken when extrapolating the pharmacokinetic data between species.

Submitted by MARCO ANTONIO FERRAZ NOGUEIRA FILHO null (nogueira-m@hotmail.com) on 2016-11-01T15:50:35Z No. of bitstreams: 1 Tese DefesaMarcoNogueira - corrigida.pdf: 3044815 bytes, checksum: e95dd666dddaa99edc99b3d3dcebfdd3 (MD5) / Rejected by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo a orientação abaixo: O arquivo submetido está sem a ficha catalográfica. A versão submetida por você é considerada a versão final da dissertação/tese, portanto não poderá ocorrer qualquer alteração em seu conteúdo após a aprovação. Corrija esta informação e realize uma nova submissão com o arquivo correto. Agradecemos a compreensão. on 2016-11-09T18:12:07Z (GMT) / Submitted by MARCO ANTONIO FERRAZ NOGUEIRA FILHO null (nogueira-m@hotmail.com) on 2016-12-05T23:16:48Z No. of bitstreams: 1 Tese DefesaMarcoNogueira - corrigida.pdf: 3227414 bytes, checksum: c8b33c8e0afd334460f9a1b891015338 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-12-06T15:21:36Z (GMT) No. of bitstreams: 1 nogueirafilho_maf_dr_arafcf.pdf: 3227414 bytes, checksum: c8b33c8e0afd334460f9a1b891015338 (MD5) / Made available in DSpace on 2016-12-06T15:21:36Z (GMT). No. of bitstreams: 1 nogueirafilho_maf_dr_arafcf.pdf: 3227414 bytes, checksum: c8b33c8e0afd334460f9a1b891015338 (MD5) Previous issue date: 2016-09-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Depois de quase 50 anos de uso na terapia, a alta potência e amplo espectro de ação asseguram que a anfotericina B (AmB) continue a ser o fármaco de escolha na terapia moderna contra infecções fúngicas invasivas. A AmB está associada a alta incidência de nefrotoxicidade e reações relacionadas à infusão, o que limita a sua utilização e muitas vezes requerem a redução da dose. Novas formulações estão sendo pesquisadas para melhorar as características farmacocinéticas da AmB, levando a novas alternativas de administração, hoje limitada à via intravenosa. No presente estudo, foi avaliado o perfil farmacocinético de um novo sistema microemulsionado de anfotericina B (MEAmB) desenhada por Franzini (2011) por via intravenosa e oral em ratos wistar (n=10), dose de 1mg / kg e 10mg / kg pelas vias intravenosa e oral respectivamente, além da avaliação preliminar de segurança. A formulação apresentou um perfil farmacocinético semelhante à AmB desoxicolato em sua administração intravenosa, sem diferenças significativas tanto nos parâmetros farmacocinéticos quanto na comparação “ponto a ponto”. A MEAmB trouxe ainda diminuição no potencial de nefrotoxicidade, mantendo os níveis de ureia e creatinina inalterados comparando-se pré e pós-exposição enquanto a AmB desoxicolato promoveu aumento significativo dos biomarcadores renais. A MEAmB apresentou uma baixa biodisponibilidade oral (apenas 5,8%) não permitindo os estudos de eficácia planejados para essa formulação. Ainda, através da aplicação da farmacometria, um modelo de farmacocinética populacional foi desenhado e validado para o melhor entendimento entre as covariáveis fisiológicas e ocasionais e a busca de possíveis fatores que impactam a farmacocinética da AmB / After nearly 50 years of use in therapy, high power and broad spectrum of action ensure that amphotericin B (AmB) remains the drug of choice in modern therapy against invasive fungal infections. The AmB is associated with high incidence of nephrotoxicity and infusion-related reactions, which limit their use and often require dose reduction. New formulations are being researched to improve the pharmacokinetic characteristics of AmB, that may lead to new alternative administration routes, limited today only to intravenous administration. In the present study, the pharmacokinetic profile of a new microemulsion system of amphotericin B (MEAmB) formulated by Franzini (2011) for intravenous and oral administration was investigated in wistar rats (n = 10), dose of 1mg / kg and 10mg / kg for intravenous and oral routes respectively, and also a preliminary assessment of safety oral administration. The formulation showed a pharmacokinetic profile similar to AmB deoxycholate in its intravenous administration, no significant differences were found in the pharmacokinetic parameters between the AmB deoxycholate and MEAmB. The MEAmB granted a statistical decrease in the nephrotoxicity potential, keeping urea and creatinine levels unchanged comparing pre- and post-exposure while AmB deoxycholate caused a significant increase in renal biomarkers. The MEAmB showed low oral bioavailability (only 5.8%) not allowing the efficacy studies planned for this formulation. A study of population pharmacokinetic was performed and a population pharmacokinetic model was designed and validated for the better understanding of the physiological and occasional covariates of AmB.

Atualmente a cucurbitacina E é considerada uma candidata a fármaco em razão de sua atividade anticâncer, reconhecimento de seus alvos moleculares e sinergismo com outros fármacos utilizados no tratamento do câncer. Porém, ainda não é possível seu uso na clínica devido a importantes lacunas na literatura relativas a ensaios de farmacocinética pré-clínicos e clínicos. A cucurbitacina E é hidrolisada a cucurbitacina I em plasma e em microssomas de fígado humano. O presente estudo visa avaliar a farmacocinética populacional e ligação as proteínas plasmáticas da cucurbitacina E e seu metabólito cucurbitacina I em plasma de ratos. O método de análise sequencial da cucurbitacina E e cucurbitacina I em plasma de ratos foi desenvolvido utilizando LCMS/ MS. Alíquotas de 50 ?L de plasma foram desproteinizadas com acetonitrila e os resíduos reconstituídos com acetonitrila:água (1:1, v/v) e adicionados do padrão interno clobazam. Os extratos foram injetados na coluna RP-18 com fase móvel constituída por mistura de acetonitrila:água:metanol (32:35:33, v/v/v). O método é preciso e exato com linearidade no intervalo de 1-100 ng de cucurbitacina E/mL de plasma e de 0,4-200 ng de cucurbitacina I/mL de plasma. O método foi aplicado na avaliação da farmacocinética da cucurbitacina E administrada a ratos machos Wistar em dose única oral (gavagem) e intravenosa de 1mg/kg dissolvida em DMSO e tampão fosfato salino pH 7,4 (5:95, v/v). As amostras seriadas de sangue foram coletadas até 24 h após a administração oral ou intravenosa. As concentrações plasmáticas de cucurbitacina E foram quantificadas até 16 h somente após a administração intravenosa, enquanto as concentrações plasmáticas de cucurbitacina I permaneceram abaixo dos valores de LIQ seguindo a administração oral ou intravenosa. O modelo de farmacocinética populacional foi desenvolvido para a cucurbitacina E administrada por via intravenosa com o auxílio do programa NONMEM com adequada qualidade de ajuste e desempenho preditivo. O perfil farmacocinético da cucurbitacina E administrada por via intravenosa foi descrito por modelo bicompartimental com distribuição e eliminação de primeira ordem com os seguintes parâmetros farmacocinéticos: tempo de liberação (D) de 0,45 h, volume de distribuição (Vd) de 27,22 L, clearance (Cl) de 4,13 L/h e meiavida de eliminação (t1/2) de 4,57 h. As interações da cucurbitacina E e cucurbitacina I com as albuminas séricas humana (HSA) e de rato (RSA) foram investigadas utilizando biossensor óptico baseado em ressonância de plasma de superfície (SPR) e espectroscopia de dicroísmo circular (CD). Os dados de ligação das cucurbitacinas a albuminas foram obtidos por experimentos de competição de CD com biliverdina. Os dados de SPR revelaram um evento de ligação inédito entre a cucurbitacina I e a HSA e as afinidades de ligação da cucurbitacina E e cucurbitacina I são maiores para a RSA do que para a HSA. A cucurbitacina E e a cucurbitacina I podem ser classificadas como substâncias de alta afinidade de ligação com a HSA e com a RSA. A análise de CD mostrou que a cucurbitacina E e a cucurbitacina I modificam a ligação da biliverdina as albuminas através de modulação alostérica oposta (positiva para HSA, negativa para RSA), confirmando a necessidade de cuidados na extrapolação de dados farmacocinéticos pré-clínicos para clínicos. / Cucurbitacin E is currently considered a drug candidate due to its anticancer activity, recognition of its molecular targets, and synergism with other drugs used for cancer treatment. However, the use of cucurbitacin E in clinical practice is not possible because of important research gaps regarding its preclinical and clinical pharmacokinetic characteristics. Cucurbitacin E is hydrolyzed to cucurbitacin I in plasma and in human liver microsomes. The aim of this study was to evaluate the population pharmacokinetics and plasma protein binding of cucurbitacin E and of its metabolite cucurbitacin I in rats. The method for the sequential analysis of cucurbitacins E and I in rat plasma was developed using LC-MS/MS. Plasma aliquots of 50 ?L were deproteinized with acetonitrile, the residues were reconstituted in acetonitrile:water (1:1, v/v), and clobazam was added as internal standard. The extracts were injected into an RP-18 column using a mobile phase consisting of a mixture of acetonitrile:water:methanol (32:35:33, v/v/v). The method was precise and accurate, showing linearities at a range of 1-100 ng cucurbitacin E/mL plasma and of 0.4-200 ng cucurbitacin I/mL plasma. The method was applied to the pharmacokinetic evaluation of cucurbitacin E administered to male Wistar rats at a single oral (gavage) or intravenous dose of 1 mg/kg dissolved in DMSO and phosphate-buffered saline, pH 7.4 (5:95, v/v). Serial blood samples were collected up to 24 h after oral or intravenous administration. The plasma concentrations of cucurbitacin E were quantified up to 16 h only after intravenous administration, while the plasma concentrations of cucurbitacin I remained below the limit of quantification after oral or intravenous administration. The population pharmacokinetic model was developed for administered intravenously cucurbitacin E using the NONMEM program, with adequate goodness of fit and predictive performance. The pharmacokinetic profile of intravenously administered cucurbitacin E was described by a two-compartment model with first-order distribution and elimination. The following pharmacokinetic parameters were obtained: release time (D) of 0.45 h, volume of distribution (Vd) of 27.22 L, clearance (Cl) of 4.13 L/h, and elimination half-life (t1/2) of 4.57 h. The interactions of cucurbitacin E and I with human (HSA) and rat (RSA) serum albumins were investigated using an optical biosensor by surface plasmon resonance (SPR) and circular dichroism (CD) spectroscopy. The binding data of the cucurbitacins to albumins were obtained by CD competition experiments with biliverdin. The SPR data revealed an undescribed binding event between cucurbitacin I and HSA and the binding affinities of cucurbitacin E and cucurbitacin I were higher for RSA than for HSA. Cucurbitacin E and cucurbitacin I can be classified as substances with high binding affinity for HSA and RSA. CD analysis showed that cucurbitacin E and cucurbitacin I modify the binding of biliverdin to albumins through opposite allosteric modulation (positive for HSA, negative for RSA), confirming that care should be taken when extrapolating the pharmacokinetic data between species.

No description available.

La fibrose kystique (FK) est une maladie qui affecte principalement les systèmes respiratoires, digestifs et reproducteurs et rend les personnes atteintes plus susceptibles aux surinfections bronchiques et aux exacerbations pulmonaires. Le dosage initial et les ajustements de dose des antibiotiques sont difficiles en raison des altérations pharmacocinétique (PK), la grande variabilité PK et l'émergence de résistance aux antibiotiques dans cette population. En guise d’introduction, le premier chapitre de ce mémoire présente la pathologie de la fibrose kystique, des principes de base en pharmacologie et en modélisation compartimentale. Le deuxième chapitre présente une revue systématique de la littérature sur les modèles PK de population des antibiotiques développés dans la population FK adulte. Cette étude a mis en évidence les facteurs démographiques et cliniques ayant le plus d'impact sur la PK des antibiotiques en FK. Par exemple, le poids corporel maigre était la covariable la plus fréquemment utilisée pour estimer les paramètres PK des β-lactamines. Le troisième chapitre montre comment les modèles PK de population peuvent être utilisés pour proposer des stratégies de dosage alternatives aux cliniciens. Les résultats ont montré que la normalisation des doses de tobramycine par la taille (à une dose de 3,4 mg/cm) permet d'obtenir des concentrations maximales et minimales de tobramycine adéquates pour un patient médian. Le quatrième chapitre présente une évaluation méthodologique de l’impact du temps de prélèvement à 8h post-dose sur la performance prédictive de modèles PK de population pour la tobramycine. Il a été démontré que les paramètres PK du deuxième compartiment sont biaisés lorsqu’estimés en utilisant des concentrations simulées issues de temps de prélèvement divergents du modèle analysé. Le cinquième chapitre illustre le développement et l’évaluation d'un nomogramme de doses initiales pour la tobramycine basé sur la taille. Les doses dérivées du nomogramme entraînent une réduction significative de la variabilité des concentrations maximales prédites par rapport à ce qui est observé en clinique, ce qui pourrait potentiellement améliorer les issues cliniques en FK. Ce mémoire a donc démontré l'importance et la pertinence de la modélisation et des simulations dans un contexte clinique afin d’améliorer la prise en charge des patients atteints de FK. / Cystic fibrosis (CF) is a progressive, hereditary disease that primarily affects the respiratory, digestive, and reproductive systems and makes patients more likely to develop bronchial bacterial infections, and subsequently experience acute pulmonary exacerbations. Effective antibiotic use is in part responsible for the decreased respiratory burden observed over the past decades. However, initial dosing and dose adjustments of antibiotics, particularly of tobramycin, is challenging due to altered pharmacokinetics (PK), high PK variability, and emergence of antibiotic resistance. The first chapter of this dissertation presents the pathology of cystic fibrosis, basic principles in pharmacology and compartmental modeling. The second chapter presents a systematic literature review of population PK models of antibiotics developed for adult patients with CF. This study highlighted the demographic and clinical factors most impacting the PK of prescribed antibiotics in this population. For example, lean body weight was the most frequently used covariate for estimating PK parameters of β-lactams. The third chapter of this memoire shows how previously developed population PK models can be leveraged to propose alternative dosing strategies to clinicians. It was found that dose normalization of tobramycin using height rather than body weight at a 3.4 mg/cm dose resulted in tobramycin maximum and residual concentrations within the target range found in published guidelines for a median patient. The fourth chapter presents a methodological evaluation of the impact of 8h post-dose sampling times on the predictive performance of tobramycin population PK models. It was shown that the PK parameters of the second compartment are biased when estimated using simulated concentrations from divergent sampling times of the analyzed model. The fifth chapter shows the development and evaluation of an initial tobramycin dosing nomogram based on height rather than body weight to further individualize antibiotic therapy for CF patients. It was found that doses derived from the proposed nomogram resulted in significantly reduced variability in predicted peak concentrations values in comparison to what is observed in clinical practice, which could potentially improve clinical outcomes for CF patients. This memoire has therefore demonstrated the importance of modeling and simulations in a clinical setting to improve the management of CF in adult patients.

Ce travail de thèse porte sur l’application de la pharmacocinétique de population dans le but d’optimiser l’utilisation de certains médicaments chez les enfants immunosupprimés et subissant une greffe. Parmi les différents médicaments utilisés chez les enfants immunosupprimés, l’utilisation du busulfan, du tacrolimus et du voriconazole reste problématique, notamment à cause d’une très grande variabilité interindividuelle de leur pharmacocinétique rendant nécessaire l’individualisation des doses par le suivi thérapeutique pharmacologique. De plus, ces médicaments n’ont pas fait l’objet d’études chez les enfants et les doses sont adaptées à partir des adultes. Cette dernière pratique ne prend pas en compte les particularités pharmacologiques qui caractérisent l’enfant tout au long de son développement et rend illusoire l’extrapolation aux enfants des données acquises chez les adultes. Les travaux effectués dans le cadre de cette thèse ont étudié successivement la pharmacocinétique du busulfan, du voriconazole et du tacrolimus par une approche de population en une étape (modèles non-linéaires à effets mixtes). Ces modèles ont permis d’identifier les principales sources de variabilités interindividuelles sur les paramètres pharmacocinétiques. Les covariables identifiées sont la surface corporelle et le poids. Ces résultats confirment l’importance de tenir en compte l’effet de la croissance en pédiatrie. Ces paramètres ont été inclus de façon allométrique dans les modèles. Cette approche permet de séparer l’effet de la mesure anthropométrique d’autres covariables et permet la comparaison des paramètres pharmacocinétiques en pédiatrie avec ceux des adultes. La prise en compte de ces covariables explicatives devrait permettre d’améliorer la prise en charge a priori des patients. Ces modèles développés ont été évalués pour confirmer leur stabilité, leur performance de simulation et leur capacité à répondre aux objectifs initiaux de la modélisation. Dans le cas du busulfan, le modèle validé a été utilisé pour proposer par simulation une posologie qui améliorerait l’atteinte de l’exposition cible, diminuerait l’échec thérapeutique et les risques de toxicité. Le modèle développé pour le voriconazole, a permis de confirmer la grande variabilité interindividuelle dans sa pharmacocinétique chez les enfants immunosupprimés. Le nombre limité de patients n’a pas permis d’identifier des covariables expliquant cette variabilité. Sur la base du modèle de pharmacocinétique de population du tacrolimus, un estimateur Bayesien a été mis au point, qui est le premier dans cette population de transplantés hépatiques pédiatriques. Cet estimateur permet de prédire les paramètres pharmacocinétiques et l’exposition individuelle au tacrolimus sur la base d’un nombre limité de prélèvements. En conclusion, les travaux de cette thèse ont permis d’appliquer la pharmacocinétique de population en pédiatrie pour explorer les caractéristiques propres à cette population, de décrire la variabilité pharmacocinétique des médicaments utilisés chez les enfants immunosupprimés, en vue de l’individualisation du traitement. Les outils pharmacocinétiques développés s’inscrivent dans une démarche visant à diminuer le taux d'échec thérapeutique et l’incidence des effets indésirables ou toxiques chez les enfants immunosupprimés suite à une transplantation. / This thesis deals with the application of population pharmacokinetics in order to optimize the use of certain medications in immunocompromised children undergoing transplantation. Among the various drugs used in immunocompromised children, the use of busulfan, tacrolimus and voriconazole remains problematic, particularly because of high interindividual variability in their pharmacokinetics necessitating individualized doses based on therapeutic drug monitoring. In addition, these drugs have not been studied in children and the doses are adapted from adults. This practice does not take into account the pharmacological characteristics of pediatrics throughout their development and makes illusory the extrapolation of data acquired in adults to children. The work done in this thesis studied sequentially the pharmacokinetics of busulfan, voriconazole and tacrolimus by a population approach (non-linear mixed effects models). The developed models have identified the main sources of interindividual variability in the pharmacokinetic parameters of these drugs. The identified covariates are body surface area and weight. These results confirm the importance of taking into account the effect of growth in children. These parameters were allometrically included in the models. This approach allows separating the effect of size from other covariates and enables the comparison of pediatric pharmacokinetic parameters with those of adults. The inclusion of these explanatory covariates should improve the management a priori of patients. The developed models were evaluated to confirm their stability, performance, and their ability to answer the original objectives of modeling. In the case of busulfan, the validated model was used to simulate dosing regimens that improve reaching the target exposure, reduce treatment failure and toxicity episodes. The developed population pharmacokinetic model for voriconazole confirmed the large variability in its pharmacokinetics in immunocompromised children. The limited data did not allow identification of covariates explaining this variability. Based on the population pharmacokinetic model of tacrolimus, a Bayesian estimator was developed, which is the first in this population of pediatric liver transplant recipients. This estimator can predict pharmacokinetic parameters and individual exposure to tacrolimus based on a limited number of samples. In conclusion, this thesis allowed applying the population pharmacokinetics approach in pediatrics to explore the characteristics of this population and describe the pharmacokinetic variability of drugs used in immunocompromised children, for the individualization of treatment. Pharmacokinetic tools developed are part of efforts to decrease the rate of treatment failure and the incidence of adverse and toxic events in immunocompromised and transplanted pediatrics.