Literature DB >> 19085044

Cyclosporine therapeutic monitoring with C(MAX) in kidney transplant recipients: racial considerations.

Amgad E El-Agroudy1, Amani M Ismail2, Mohamed Nassar2, Mohamed A Ghoneim2.   

Abstract

BACKGROUND: The aim of the study was to assess whether the C(2) level is a good parameter to predict a drug's maximal concentration C(MAX) values in Egyptian kidney transplant recipients (KTR).
METHODS: Fifty stable kidney transplant recipients (KTR) with a previously confirmed diagnosis of schistosomal infection compared to KTR (n = 50) without schistosomal infection regarding CsA concentrations at time 0 (trough), 1.5, 2, 2.5, 3, and 3.5 h post-CsA. Statistical significance of linear regression between different CsA time concentrations and drug dosages was calculated.
RESULTS: Patients in schistosomal group, had significantly lower C(2) levels (511 +/- 118 ng/ml) compared with control group (669 +/- 213 ng/ml) (P < 0.05), whereas C(2.5) level was significantly higher (730 +/- 215 and 527 +/- 129 ng/ml, respectively; P < 0.05). Only C(2.5) in schistosomal group had a significant linear regression relationship with both morning cyclosporine (CsA) dose and CsA dose expressed as mg/kg/day (P = 0.0123, r = 0.573018).
CONCLUSIONS: Egyptian patients have special characteristics in drug absorption and metabolism, mostly due to schistosomal infection, and they may need the use of C(2.5) for monitoring of CsA. If confirmed by subsequent larger experience, these findings may have a significant impact on our management of CyA immunosuppression in clinical renal transplantation in certain ethnicities.

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Year:  2008        PMID: 19085044     DOI: 10.1007/s10157-008-0111-0

Source DB:  PubMed          Journal:  Clin Exp Nephrol        ISSN: 1342-1751            Impact factor:   2.801


  17 in total

Review 1.  Renal transplantation: the impact of schistosomiasis.

Authors:  A A Shokeir
Journal:  BJU Int       Date:  2001-12       Impact factor: 5.588

2.  Recommendations for the implementation of Neoral C(2) monitoring in clinical practice.

Authors:  Edward Cole; Karsten Midtvedt; Atholl Johnston; James Pattison; Catherine O'Grady
Journal:  Transplantation       Date:  2002-05-15       Impact factor: 4.939

3.  Neoral (cyclosporine) C2 monitoring in renal transplant recipients: a single-center experience in Asia.

Authors:  H-S Wong; Z Morad
Journal:  Transplant Proc       Date:  2003-02       Impact factor: 1.066

4.  Changes in the expression of cytochrome P450 isozymes and related carcinogen metabolizing enzyme activities in Schistosoma mansoni-infected mice.

Authors:  S A Sheweita; J Mubark; M J Doenhofe; M H Mostafa; G P Margison; P J O'Connor; R H Elder
Journal:  J Helminthol       Date:  2002-03       Impact factor: 2.170

5.  Role of intestinal P-glycoprotein (mdr1) in interpatient variation in the oral bioavailability of cyclosporine.

Authors:  K S Lown; R R Mayo; A B Leichtman; H L Hsiao; D K Turgeon; P Schmiedlin-Ren; M B Brown; W Guo; S J Rossi; L Z Benet; P B Watkins
Journal:  Clin Pharmacol Ther       Date:  1997-09       Impact factor: 6.875

6.  Reduced inter- and intrasubject variability in cyclosporine pharmacokinetics in renal transplant recipients treated with a microemulsion formulation in conjunction with fasting, low-fat meals, or high-fat meals.

Authors:  B D Kahan; J Dunn; C Fitts; D Van Buren; D Wombolt; R Pollak; R Carson; J W Alexander; M Choc; R Wong
Journal:  Transplantation       Date:  1995-02-27       Impact factor: 4.939

Review 7.  Schistosomiasis.

Authors:  A A El-Garem
Journal:  Digestion       Date:  1998-08       Impact factor: 3.216

8.  Impact of schistosomiasis on patient and graft outcome after kidney transplantation.

Authors:  M A Sobh; A E el-Agroudy; F E Moustafa; A A Shokeir; A el-Shazly; M A Ghoneim
Journal:  Nephrol Dial Transplant       Date:  1992       Impact factor: 5.992

9.  Intensity of Schistosoma mansoni infection determines alterations in hepatic drug metabolism.

Authors:  Y S Naik; J A Hasler
Journal:  J Egypt Soc Parasitol       Date:  1995-04

10.  Clinical benefits of neoral C2 monitoring in the long-term management of renal transplant recipients.

Authors:  Edward Cole; Nava Maham; Carl Cardella; Daniel Cattran; Stanley Fenton; Jayne Hamel; Catherine O'Grady; Robert Smith
Journal:  Transplantation       Date:  2003-06-27       Impact factor: 4.939

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