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Wada K, Takada M, Kotake T, Ochi H, Morishita H, Komamura K, Oda
N, Mano A, Kato TS, Hanatani A, Nakatani T. Circ J. 2007
Jul;71(7):1022-8.
Limited sampling strategy for
mycophenolic acid in Japanese heart transplant recipients:
comparison of cyclosporin and tacrolimus treatment.
Department of Pharmacy, National Cardiovascular Center,
Fujishirodai, Suita, Japan.
kwada@hsp.ncvc.go.jp
BACKGROUND: The purpose of the study was to characterize the
pharmacokinetics of mycophenolic acid (MPA) in Japanese heart
transplant recipients and to find the time point that has the
best correlation with the MPA area under the plasma
concentration curve (AUC). METHODS AND RESULTS: Twenty-two
Japanese recipients treated with mycophenolate mofetil were
evaluated in the study. Approximately 9 months after
transplantation, the area under the MPA serum concentration-time
curve from 0 to 12 h (AUC(0-12 h)) was evaluated. The MPA
AUC(0-12 h) h values in the cyclosporine (CsA) and tacrolimus
(FK) groups ranged from 13.11 to 50.98 mug . h/ml and from 39.19
to 93.18 mug . h/ml, respectively. Fourteen models were
developed and analyzed for their ability to estimate the MPA
AUC(0-12 h) based on a limited number of samples in the CsA
group. Sixteen models were developed in the FK group. The best
model for predicting the full MPA AUC(0-12 h) in the CsA group
was a 3-time-point model that included C(0 h), C(1 h) and C(2 h)
(r(2), 0.96; mean prediction error, 0.15+/-7.85%); a
2-time-point model that included C(0 h), and C(2 h) (r(2), 0.94;
mean prediction error, 0.495+/-10.35%) was also reliable. In the
FK group, a 3-time-point model that included C(1 h), C(2 h) and
C(4h) (r(2), 0.73; mean prediction error, 2.73+/-17.09%) was the
best model for predicting the full MPA AUC(0-12 h), but it was
not reliable in clinical practice. CONCLUSION: A 3-(C(0 h), C(1
h) and C(2 h)) and a 2-time-point model (C(0 h) and C(2 h)) are
useful for predicting the full MPA AUC(0-12 h) in Japanese heart
transplant recipients treated with CsA but not with FK.
PMID: 17587705 |
