Therapeutic drug monitoring of cyclosporine microemulsion in patients with corticosteroid-resistant systemic lupus erythematosus
| Autor: | Daisuke Wakura, Toshiaki Hanafusa, Shigeki Makino, Yumiko Wada, Takuya Kotani, Tohru Takeuchi, Reiko Wakura |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Time Factors Adolescent medicine.drug_class Pharmacology Young Adult Rheumatology Adrenal Cortex Hormones medicine Humans Lupus Erythematosus Systemic In patient Dosing Immunosuppressive effect Retrospective Studies medicine.diagnostic_test business.industry Therapeutic effect Cyclosporine microemulsion Middle Aged Therapeutic drug monitoring Cyclosporine Corticosteroid Female Drug Monitoring business Immunosuppressive Agents Blood sampling |
| Zdroj: | Modern rheumatology. 25(5) |
| ISSN: | 1439-7609 |
| Popis: | We retrospectively examined how the cyclosporine-A (CSA) microemulsion administration mode affected blood CSA levels, as well as how the dose and blood levels of CSA affected its therapeutic effect against systemic lupus erythematosus (SLE).We calculated the area under the blood concentration time curve (AUC) of CSA in 16 patients with corticosteroid-resistant SLE, and analyzed its correlation with CSA levels at the blood sampling time points to investigate the optimum monitoring and dosing regimen.The blood CSA level peaked at 2 h after administration (C2) in all patients. AUC0-6, which most markedly reflects the immunosuppressive effect, significantly correlated with C2 (R2 = 0.905), but not with the trough (C0). In concentration/dose ratio (C/D) of CSA, C2/D level was significantly higher when administered once daily before breakfast than when administered in the divided dose after meals (R2 = 0.355, P = 0.015), but not C0/D. During the 6-month follow-up, the CSA C2 tended to correlate with improvement in SLE disease activity index 2000 (R2 = 0.633, P = 0.067).The treatment with a single dose of CSA before breakfast, followed by monitoring of C2, may be useful for improving the therapeutic effect in patients with corticosteroid-resistant SLE. |
| Databáze: | OpenAIRE |
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