Midostaurin administration in two hemodialysis patients
Autor: | Musa Mulseh, Amanda N. Seddon, Laura Geswein, Eris Tollkuci |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.drug_class medicine.medical_treatment Antineoplastic Agents Pharmacology Tyrosine-kinase inhibitor End stage renal disease Food and drug administration 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal Dialysis hemic and lymphatic diseases medicine Humans Pharmacology (medical) Midostaurin Protein Kinase Inhibitors Aged business.industry Myeloid leukemia Middle Aged Staurosporine Leukemia Myeloid Acute Oncology chemistry 030220 oncology & carcinogenesis Kidney Failure Chronic Female Hemodialysis business Tyrosine kinase 030215 immunology |
Zdroj: | Journal of Oncology Pharmacy Practice. 25:1285-1288 |
ISSN: | 1477-092X 1078-1552 |
DOI: | 10.1177/1078155218801067 |
Popis: | Midostaurin is a multitargeted tyrosine kinase inhibitor approved by the Food and Drug Administration for FMS-related tyrosine kinase 3-positive acute myeloid leukemia in combination with standard daunorubicin and cytarabine induction and high-dose cytarabine consolidation. The pharmacokinetics of midostaurin in the setting of severe renal impairment (creatinine clearance [CrCl] 15-29 mL/min utilizing Cockcroft-Gault method) and end-stage renal disease are unknown. Midostaurin is primarily metabolized by the liver through the CYP3A4 enzyme with fecal excretion accounting for 95% of the dose (4% recovered as unchanged drug). Only 5% of the parent drug is found in the urine. This is the first case report documenting the administration of midostaurin in two patients with end-stage renal disease on HD. Given the limited excretion of both active and inactive metabolites of midostaurin in the urine, one does not expect an increase in toxicity related to impaired drug excretion. Although this report describes the likely successful utilization of midostaurin, caution should be exercised when administering in patient populations with end organ disease. Medical history, concomitant comorbidities, and goals of therapy should be taken into account. |
Databáze: | OpenAIRE |
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