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Students

Johanna Melin
Pharmacist / Freie Universität Berlin

PhD Student Year Representative
Begin: March 2013 - End: December 2017
Supervisor: Prof. Charlotte Kloft
Co-Supervisor: Prof. Wilhelm Huisinga
Mentor: Boehringer Ingelheim

PhD Project

Pharmacometric approaches to assess hydrocortisone therapy in paediatric patients with adrenal insufficiency (PhD thesis)

Scientific interests

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders leading to decreased or no synthesis of cortisol. Low concentrations of cortisol leads to an imbalance in the steroid synthesis pathway, thereby, resulting in increased levels of androgens followed by symptoms, such as virilisation, hirsuitism and preoccus puberty. The prevalence of the more severe form is 1/15000 in newborns, but the less severe form is more prevalent (1/1000) and can sometimes be asymptomatic.

The recommended cortisol substitution therapy for growing paediatric patients constitutes of hydrocortisone. Drug monitoring in these patients may be problematic, since too high doses may increase the risk for Cushing’s syndrome, whereas too low doses may increase risk of adrenal crisis or disease progression. The therapeutic regimen is currently chosen based on empirical knowledge and is currently not standardised. We, therefore, see a need for improvement regarding the dosing regimen in this population to improve treatment outcome.

The aim of my PhD thesis will be to use a population-based pharmacokinetic approach to characterise the pharmacokinetics of hydrocortisone in paediatric patients from infants to adults. By relating the pharmacokinetics of hydrocortisone to disease-related biomarkers or patient characteristics, we hope to establish a pharmacokinetic-pharmacodynamic model, which later will be used in order to optimise therapy for paediatric patients with CAH.
The ultimate goal will be to establish a Therapeutic Drug Monitoring, which should be eval-
uated and optimally later could be used in the clinic.

Publications

  • J Melin.
    Population Pharmacokinetic Analysis of atorvastatin and rosuvastatin in critically ill patients with sepsis.
    Master Thesis in Pharmacy. University of Queensland, Brisbane, Australia (2012).

Presentations

Education

  • 03/2013 - : Graduate Research Training Program ‘Pharmacometrics & Computational Disease Modeling’ at the Freie Universität Berlin
  • 08/2012: Registered Pharmacist
  • 02/2012 - 07/2012: Pre-registration Internship. Apotek Hjärtat Bellevuegården (Malmö, Sweden)
  • 08/2011 – 01/2012: Master Thesis work “Population Pharmacokinetic Analysis of atorvastatin and rosuvastatin in critically ill patients”. Therapeutics Research Center, School of Medicine, University of Queensland (Brisbane, Australia)
  • 08/2006 - 07/2012: Master of Science, Pharmacy. University of Gothenburg (Gothenburg, Sweden)