Abbreviated area-under-the-curve strategy for monitoring cyclosporine microemulsion therapy in immediate posttransplant period

Amante, Angel J.; Kahan, Barry D.

doi:10.1093/clinchem/42.8.1294

Cited by 60 publications

(23 citation statements)

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“…Doses were adjusted independently to attain predetermined therapeutic levels of drug exposure. The daytime area under the concentration time curve (AUC) was estimated by the two‐point technique (4) and was used to adjust the morning dose. The initial target was set at 7200–8400 ng/h/mL.…”

Section: Methodsmentioning

confidence: 99%

Delayed graft function may not adversely affect short‐term renal allograft outcome

Browne

Holt

Emovon

2003

Clinical Transplantation

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Sixty consecutive patients received 64 allografts (four double grafts). In all, 17 patients required dialysis and were considered to have DGF. Eight of these patients received marginal organs turned down by at least one other centre. Cold ischaemia time was significantly longer in patients with DGF (24 h vs. 19 h, P < 0.01) All patients were treated as planned and there were no major protocol violations. One patient had primary non-function and was excluded from analysis. CsA trough and Cav values were similar between groups. Mean serum creatinine levels (mg/mL) fell more slowly in patients with DGF but there was no significant difference by 3 months (1.7 vs. 1.5) and the creatinine clearance was not significantly different between the groups after 1 year (71 cm3/min in DGF vs. 61 cm3/min, P = 0.13). Our data demonstrate that alterations in routine immunosuppressive strategies may not be necessary to achieve equivalent outcomes in patients with DGF.

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Section: Methodsmentioning

confidence: 99%

Delayed graft function may not adversely affect short‐term renal allograft outcome

Browne

Holt

Emovon

2003

Clinical Transplantation

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“…In addition, scheduled protocol AUC computations were obtained in all patients approximately in 1 wk, 1, 2, 3, and 6 months after transplantation. An abbreviated two‐point formula was used to estimate AUC 0−12 [196 + 2.4 ( C 2 ) + 7.7 ( C 6 )] (8). Before each clinical visit, patients were instructed to take their regular evening CsA dose and arrive at the transplant centre in sufficient time to obtain blood for C 0 .…”

Section: Therapeutic Drug Monitoringmentioning

confidence: 99%

Effect of cyclosporin pharmacokinetics on renal allograft outcome in African‐Americans

Emovon¹,

King²,

Holt

et al. 2003

Clinical Transplantation

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African-Americans (A-As) experience inferior outcome after transplantation compared with other ethnic groups. Bioavailability of cyclosporin (CsA) has been implicated as a possible contributing factor. This paper describes the outcome of 32 A-A recipients of de novo renal allograft who received CsA-based triple immunotherapy according to individual pharmacokinetic profiles. Patients received CsA-microemulsion q 12 h, dosed initially at 3.5 mg/kg (8 am) and 3.0 mg/kg (8 pm). The am and pm doses were independently adjusted to achieve a 12-h area under the concentration-time curve (AUC0-12) of 6600-7200 nghr/mL and morning trough level (C0) of 250-325 ng/mL, respectively. Mean age was 43 +/- 12 yr, 37% (12) female. Mean AUC0-12 in 1 wk, 1, 3, 6, and 12 months were 7810 +/- 1880 nghr/mL, 9057 +/- 2097 nghr/mL, 7674 +/- 1912 nghr/mL, 7132 +/- 2040 nghr/mL, and 6503 +/- 1410 ngl/h with corresponding C0 of 301 +/- 79 ng/mL, 316 +/- 66 ng/mL, 275 +/- 59 ng/mL, 273 +/- 66 ng/mL, and 224 +/- 49 ng/mL, respectively. Acute rejection occurred in two patients (6%) 1 yr after transplantation. Prospective use of CsA pharmocokinetic profiles improves renal allograft outcome in A-As.

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“…Because AUC reflects systemic drug exposure, several groups have used sparse-sampling algorithms [limited sampling models (LSMs)] as a way of predicting AUCs without the need for large numbers of bloodlevel measurements [6,7]. Exposure during the first 4 h (AUC 0-4h ), the area of greatest inter-and intrapatient variability, is a reliable estimate of total drug exposure throughout the dosing interval (AUC 0-12h ) [8].…”

Section: Introductionmentioning

confidence: 99%

A compartmental pharmacokinetic model of cyclosporin and its predictive performance after Bayesian estimation in kidney and simultaneous pancreas-kidney transplant recipients

Cremers¹,

Scholten²,

Schoemaker³

et al. 2003

Nephrology Dialysis Transplantation

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A population two-compartment model is presented to reliably estimate the CsA AUC in KTA and SPKT recipients. The performance of the model to estimate the AUC is comparable to the performance of two published LSMs in KTA patients, but markedly better in SPKT patients. Combined with Bayesian fitting, the model is very flexible since sampling times are not rigid and can be varied as long as dosing and sampling times are recorded accurately. The model has already proven to be clinically useful and is currently used to further investigate CsA in an integrated pharmacokinetic/pharmacodynamic model.

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Abbreviated area-under-the-curve strategy for monitoring cyclosporine microemulsion therapy in immediate posttransplant period

Cited by 60 publications

References 0 publications

Delayed graft function may not adversely affect short‐term renal allograft outcome

Delayed graft function may not adversely affect short‐term renal allograft outcome

Effect of cyclosporin pharmacokinetics on renal allograft outcome in African‐Americans

A compartmental pharmacokinetic model of cyclosporin and its predictive performance after Bayesian estimation in kidney and simultaneous pancreas-kidney transplant recipients

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