Literature DB >> 17712551

Evaluation of limited sampling strategies for tacrolimus.

Robert A M Op den Buijsch1, Afke van de Plas, Leo M L Stolk, Maarten H L Christiaans, Johannes P van Hooff, Nas A Undre, Marja P van Dieijen-Visser, Otto Bekers.   

Abstract

OBJECTIVE: In literature, a great diversity of limited sampling strategies (LSS) have been recommended for tacrolimus monitoring, however proper validation of these strategies to accurately predict the area under the time concentration curve (AUC0-12) is limited. The aim of this study was to determine whether these LSS might be useful for AUC prediction of other patient populations.
METHODS: The LSS from literature studied were based on regression equations or on Bayesian fitting using MWPHARM 3.50 (Mediware, Groningen, the Netherlands). The performance was evaluated on 24 of these LSS in our population of 37 renal transplant patients with known AUCs. The results were also compared with the predictability of the regression equation based on the trough concentrations C0 and C12 of these 37 patients. Criterion was an absolute prediction error (APE) that differed less than 15% from the complete AUC0-12 calculated by the trapezoidal rule.
RESULTS: Thirteen of the 18 (72%) LSS based on regression analysis were capable of predicting at least 90% of the 37 individual AUC0-12 within an APE of 15%. Additionally, all but three LSS examined gave a better prediction of the complete AUC0-12 in comparison with the trough concentrations C0 or C12 (mean 62%). All six LSS based on Bayesian fitting predicted <90% of the 37 complete AUC0-12 correctly (mean 67%).
CONCLUSIONS: The present study indicated that implementation of LSS based on regression analysis could produce satisfactory predictions although careful evaluation is necessary.

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Year:  2007        PMID: 17712551      PMCID: PMC2039832          DOI: 10.1007/s00228-007-0354-9

Source DB:  PubMed          Journal:  Eur J Clin Pharmacol        ISSN: 0031-6970            Impact factor:   2.953


  26 in total

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2.  Whole blood and plasma levels of FK 506 after liver transplantation: correlation with toxicity.

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Review 3.  Therapeutic drug monitoring of tacrolimus in clinical transplantation.

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4.  Some suggestions for measuring predictive performance.

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Review 5.  A risk-benefit assessment of tacrolimus in transplantation.

Authors:  M Winkler; U Christians
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Authors:  Christine E Staatz; Susan E Tett
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Review 7.  Population Pharmacokinetic Modelling and Bayesian Estimation of Tacrolimus Exposure: Is this Clinically Useful for Dosage Prediction Yet?

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Review 9.  Pharmacokinetics, Pharmacodynamics and Pharmacogenomics of Immunosuppressants in Allogeneic Haematopoietic Cell Transplantation: Part I.

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10.  Predicting tacrolimus concentrations in children receiving a heart transplant using a population pharmacokinetic model.

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