Population pharmacokinetics of tacrolimus in Thai kidney transplant patients: comparison with similar data from other populations
| Autor: | N Techawathanawanna, W Treyaprasert, S Praisuwan, Somratai Vadcharavivad, Yingyos Avihingsanon |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Prednisolone Population Calcineurin Inhibitors Renal function chemical and pharmacologic phenomena Pharmacology 030226 pharmacology & pharmacy Gastroenterology Models Biological Tacrolimus 03 medical and health sciences Hemoglobins Young Adult 0302 clinical medicine Pharmacokinetics Internal medicine medicine Humans Pharmacology (medical) Tissue Distribution education Kidney transplantation Aged Volume of distribution education.field_of_study medicine.diagnostic_test business.industry Middle Aged medicine.disease Thailand Kidney Transplantation Calcineurin surgical procedures operative Nonlinear Dynamics Therapeutic drug monitoring 030220 oncology & carcinogenesis Female business Immunosuppressive Agents Glomerular Filtration Rate |
| Zdroj: | Journal of clinical pharmacy and therapeutics. 41(3) |
| ISSN: | 1365-2710 |
| Popis: | SummaryWhat is known and objective Tacrolimus, the most widely used calcineurin inhibitor in kidney transplantation, has a narrow therapeutic window with high interindividual variability in its pharmacokinetics. Clinically feasible models that combine important factors may help guide individual tacrolimus dosage adjustment in kidney transplant patients. The purpose of this study was to develop a population pharmacokinetic model and investigate the influence of clinical factors on the pharmacokinetics of tacrolimus in adult Thai kidney transplant patients from routine data monitoring. Methods A total of 1183 whole blood concentrations from 96 patients were characterized using nonlinear mixed-effects modelling. Clinical factors tested for influence on pharmacokinetic parameters were weight, haemoglobin, duration of tacrolimus therapy, prednisolone dose, serum albumin and estimated glomerular filtration rate. Results and discussion A one-compartment model with first-order absorption best described the data. The population estimate of tacrolimus apparent clearance (CL/F) and apparent volume of distribution (V/F) in the final population model was 21·5 L/h (95% CI; 18·38, 24·34) and 333 L (95% CI; 222·66, 484·35), respectively. CL/F increased with decreasing haemoglobin levels and decreased with increasing duration of tacrolimus therapy (both P |
| Databáze: | OpenAIRE |
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