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Titolo:
Correlation between pretransplantation test dose cyclosporine pharmacokinetic profiles and posttransplantation sirolimus blood levels in renal transplant recipients
Autore:
Kaplan, B; Meier-Kriesche, HU; Napoli, KL; Kahan, BD;
Indirizzi:
UnivTXexas, Sch Med, Dept Surg, Div Immunol & Organ Transplantat, Houston,Univ Texas Houston TX USA 77030 iv Immunol & Organ Transplantat, Houston, Univ Texas, Sch Med, Dept Med, Div Nephrol, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 t Med, Div Nephrol, Houston, TX 77030 USA
Titolo Testata:
THERAPEUTIC DRUG MONITORING
fascicolo: 1, volume: 21, anno: 1999,
pagine: 44 - 49
SICI:
0163-4356(199902)21:1<44:CBPTDC>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
ERYTHROMYCIN BREATH TEST; 3A ENZYMES; RAPAMYCIN; METABOLISM; CYTOCHROME-P450; BIOAVAILABILITY; REJECTION; CLEARANCE; THERAPY; MODEL;
Keywords:
cyclosporine; pharmacokinetics; rapamycin; renal; sirolimus;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Kahan, BD Univin,SuiteSch Med, Dept Surg, Div Immunol & Organ Transplantat, 6431 Fann Univ Texas 6431 Fannin,Suite 6-240 Houston TX USA 77030 431 Fann
Citazione:
B. Kaplan et al., "Correlation between pretransplantation test dose cyclosporine pharmacokinetic profiles and posttransplantation sirolimus blood levels in renal transplant recipients", THER DRUG M, 21(1), 1999, pp. 44-49

Abstract

We sought to determine whether pretransplantation test dose pharmacokinetic measurements of cyclosporine (CsA) concentrations would forecast the posttransplantation blood concentrations of sirolimus in renal transplant patients treated de novo with CsA. sirolimus, and prednisone. All 44 renal transplant recipients enrolled in Phase I/II studies of de novo posttransplantation therapy with sirolimus, CsA, and prednisone underwent pretransplantation pharmacokinetic profiling after having received paired intravenous (IV) and oral test doses of CsA. After transplantation, all patients were treatedwith CsA on a once- or twice-daily schedule (according to a concentration-controlled regimen), with tapering doses of prednisone, and with fu;ed doses of sirolimus on a once-daily schedule. Patients were divided into four cohorts based on the deviation of their pretransplantation CsA clearance or bioavailability values from the mean. Patients with high pretransplantation CsA clearance rates displayed a significantly lower mean posttransplantation value of sirolimus trough concentrations than patients with low pretransplantation CsA clearance rates. In contrast, values for pretransplantation absolute oral CsA bioavailability failed to correlate with the mean posttransplantation concentration of sirolimus but did predict posttransplantation CsA bioavailability. Therefore, pretransplantation CsA clearance rate estimates may forecast posttransplantation sirolimus concentrations, possibly guiding use of sirolimus therapy to achieve an optimal ratio of concentration-dependent immunosuppressive versus toxic effects.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 20:12:42