[Evidence-based therapeutic drug monitoring for nevirapine].

Autor:	Muret P; Laboratoire de Pharmacologie Clinique et Toxicologie, CHU Besançon, France. patrice.muret@univ-fcomte.fr, Piedoux S, Solas C, Quaranta S
Jazyk:	francouzština
Zdroj:	Therapie [Therapie] 2011 May-Jun; Vol. 66 (3), pp. 187-95. Date of Electronic Publication: 2011 Aug 09.
DOI:	10.2515/therapie/2011030
Abstrakt:	Nevirapine, a HIV non nucleosidic reverse transcriptase inhibitor, displays an inter-individual variability in its pharmacokinetics parameters, related to its hepatic metabolism. Based on literature, is the nevirapine therapeutic drug monitoring relevant? In naïve and pre-treated HIV infected patients, the probability of achieving and maintaining an undetectable HIV viral load was significantly associated with a nevirapine plasma trough concentration (C(trough)) > 4 000 ng/mL. The probability of virologic failure was significantly associated with a C(trough) < 3 000 ng/mL. Concerning the exposure-toxicity relationship, the emergence of hepatotoxicity was more frequently associated with high C(trough), especially in case of HCV coinfection. Non-randomized studies have reported the interest of nevirapine therapeutic drug monitoring to optimize the virologic response and, to a lesser extent, to prevent hepatotoxicity. Therefore, the level of evidence of the interest of nevirapine therapeutic drug monitoring is "recommended". (© 2011 Société Française de Pharmacologie et de Thérapeutique.)
Databáze:	MEDLINE
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