PhD candidate Alanna McEneny-King received a 2017 doctoral Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-D) from the Canadian Institutes of Health Research (CIHR). The $105,000 grant supports McEneny-King’s research developing mathematical models to improve dosing of people with hemophilia.
Hemophilia is an inherited bleeding disorder caused by an inability to produce a certain component in blood that allows for clotting. Without this component, called a clotting factor, people with hemophilia experience sudden bleeding and eventually develop joint damage. Typically, treatment involves giving a regular infusion of the missing factor based on the patient’s weight. However, even patients of similar weights respond very differently to the infusions. As a result, patients frequently receive too much or not enough of their treatments, which endangers health.
McEneny-King examines these complexities in treatment and focuses on a process called dose individualization.
“For hemophilia,” she explains, “treatments can be more effective if doses are determined at the individual level, based on a variety of characteristics. However, the traditional process for individualizing doses in this way involves rigorous blood sampling and complex calculations. It’s a difficult process to carry out in a clinical setting like a doctor’s office.”
To improve on this process, McEneny-King is applying population pharmacokinetic methods. Pharmacokinetics is a field that uses mathematics to describe a drug’s absorption, distribution, metabolism, and excretion from the body. By harnessing information from large populations of patients, McEneny-King can identify how traits like age, weight, and sex impact response to medication. Using mathematical models, she can see the effect of these traits working in combination.
“Alanna's work will directly impact hemophilia patients by allowing for individualized dosing of their medications, potentially leading to fewer bleeds,” explains Professor Andrea Edginton, McEneny-King’s PhD supervisor.
The CIHR award also recognized McEneny-King’s unique focus on accessibility of research. Her work is part of the Web Accessible Population Pharmacokinetics Service for Hemophilia (WAPPS-Hemo), a project run out of McMaster University. This online repository houses the largest collection of clotting factor pharmacokinetic data in the world and continues to grow as more clinicians join the network. The goal of the site is to provide hemophilia treaters with a tool that allows them to easily tailor doses to individual patients.
McEneny-King’s pharmacokinetic models benefit both patients and healthcare providers. Those with hemophilia will receive safer and more effective treatment, and clinicians gain access to integrated knowledge that they can incorporate into routine practice.