Clinical efficacy and pharmacokinetics of tacrolimus in children with steroid-resistant nephrotic syndrome

Abstract

Tacrolimus had beneficial clinical response in SRNS. Target C0 and AUC0-12 h level for treatment remission was higher than those in relapse in children with SRNS but was lower than required in transplant recipient.

Population pharmacokinetics of tacrolimus in children with nephrotic syndrome

“…It has been reported that time post-transplantation in days, hematocrit, liver weight and liver function influenced tacrolimus elimination [28][29][30][31]. Nephrotic syndrome induces proteinuria, hypoalbuminemia, hypertriglyceridemia and hypercholesterolemia [32,33]. These characteristics may have an impact on TAC pharmacokinetics.…”

Off‐label use of tacrolimus in children with glomerular disease: Effectiveness, safety and pharmacokinetics

“…These pharmacokinetics data assessed in paediatric organ transplant patients may not be directly used in paediatric patients with glomerular disease . Paediatric patients with glomerular disease may have hypoproteinaemia . Intestinal oedema caused by hypoproteinaemia may affect tacrolimus absorption.…”

“…The recommended target C 0 for children with nephrotic syndrome is 5‐10 ng/mL, which is lower than 10‐20 ng/mL during the immediate post‐transplantation period used for all types of paediatric organ transplantations . The target C 0 and AUC 0‐12 h level for treatment remission are higher than those in relapse in children with SRNS …”

“…92 The target C 0 and AUC 0-12 h level for treatment remission are higher than those in relapse in children with SRNS. 45 T A B L E 2 Number and proportion of adverse drug events in clinical studies of tacrolimus in the treatment of nephrotic syndrome in children 31,32,[36][37][38][39][40][41][42][47][48][49][50]66 In the first population pharmacokinetic model of tacrolimus in children with nephrotic syndrome, body weight, CYP3A5 genotype had significant impact on tacrolimus pharmacokinetics. 93 The mean clearance/bioavailability (CL/F) of tacrolimus is in agreement with previously reported values of tacrolimus in paediatric kidney transplant patients.…”

A Brief Overview Of Childhood Nephrotic Syndrome: Review

“…Takrolimus SDiNS'li çocuk-larda etkin şekilde kullanılmaktadır. 66,67 Siklosporin için istenen açlık kan düzeyi 80-120 ng/mL, takrolimus için 4-7 ng/mL'dir. 3 Kalsinörin inhibitörleri ile tedavi eğer hasta tam ya da parsiyel remisyonda ise iki-üç yıl kadar sürdü-rülür.…”