2026 CONVENTION
Development of a PK-Sim-based PBPK model for cenobamate in healthy adults
Cenobamate is an antiseizure medication approved for the treatment of focal-onset seizures. This study aimed to develop a physiologically based pharmacokinetic (PBPK) model of cenobamate in healthy adults and evaluate its applicability under single- and multiple-dose conditions. A whole-body PBPK model was developed in PK-Sim using reported physicochemical, pharmacokinetic, and clinical data. Model development was based on single ascending dose data from 5 to 750 mg and further evaluated using multiple ascending dose data. To account for dose-dependent pharmacokinetics, nonlinear metabolism was described using Michaelis-Menten kinetics with CYP- and UGT-mediated pathways. Selected model parameters were optimized using observed concentration-time profiles. The model reproduced the overall concentration-time profiles across the evaluated dose range and captured dose-dependent changes in exposure. Incorporation of nonlinear metabolism improved model performance, particularly at higher doses, and the model showed reasonable agreement with observed profiles after repeated dosing. The developed PBPK model provides a mechanistic framework for characterizing cenobamate pharmacokinetics and may support prediction across dosing regimens and future extrapolation to clinically relevant populations.