Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
| Autor: | Jose C Tutor, Natalia Lampon, Rafael Romero, María J. Tutor-Crespo |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Biochemistry (medical) Clinical Biochemistry Urology Area under the curve General Medicine Mycophenolate medicine.disease Tacrolimus Mycophenolic acid Pharmacokinetics Therapeutic drug monitoring Concomitant medicine business Kidney transplantation medicine.drug |
| Zdroj: | cclm. 49:1167-1170 |
| ISSN: | 1437-4331 1434-6621 |
| DOI: | 10.1515/cclm.2011.191 |
| Popis: | Background: Recently, the use of the truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid (MPA) has been proposed for therapeutic monitoring in liver transplant recipients. The aim of our study was the evaluation of the clinical usefulness of truncated AUC0–2 in kidney transplant patients. Methods: Plasma MPA was measured in samples taken before the morning dose of mycophenolate mofetil, and one-half and 2 h post-dose, completing 63 MPA concentration-time profiles from 40 adult kidney transplant recipients. The AUC from 0 to 12 h (AUC0–12) was calculated using the validated algorithm of Pawinski et al. The truncated AUC0–2 was calculated using the linear trapezoidal rule, and extrapolated to 0–12 h (trapezoidal extrapolated AUC0–12) as previously described. Results: Algorithm calculated and trapezoidal extrapolated AUC0–12 values showed high correlation (r=0.995) and acceptable dispersion (ma68=0.71 μg·h/mL), median prediction error (6.6%) and median absolute prediction error (12.6%). The truncated AUC0–2 had acceptable diagnostic efficiency (87%) in the classification of subtherapeutic, therapeutic or supratherapeutic values with respect to AUC0–12. However, due to the high inter-individual variation of the drug absorption-rate, the dispersion between both pharmacokinetic variables (ma68=6.9 μg·h/mL) was unacceptable. Conclusions: The substantial dispersion between truncated AUC0–2 and AUC0–12 values may be a serious objection for the routine use of MPA AUC0–2 in clinical practice. |
| Databáze: | OpenAIRE |
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