PMID: 8588231Dec 1, 1995Paper

Challenges in cyclosporine therapy: the role of therapeutic monitoring by area under the curve monitoring

Therapeutic Drug Monitoring
B D KahanL P Rutzky

Abstract

Cyclosporine has revolutionized the practice of transplantation, but its clinical application has been beclouded by a narrow therapeutic window between immunosuppressive and nephrotoxic concentrations. Marked intra- and interindividual pharmacokinetic differences preclude the use of routine dosing regimens. For example, at the intraindividual level, cyclosporine absorption improves during the first 90 days after institution of therapy. A wide range of demographic factors, namely, age, race, and concomitant drug therapy, as well as individual-specific factors produce unique pharmacokinetic behaviors in any given patient. We introduced a pharmacokinetic strategy for cyclosporine administration almost 10 years ago based on the observation that the best estimate of drug exposure was the area under the concentration-time kinetic curve (AUC) not the trough level. Early studies documented the relation between AUC and the incidence of acute rejection. Subsequent studies revealed that not only is the AUC an important predictor, but so is the consistency of drug absorption over time; namely, patients with variations > 25% among AUC determinations display an increased risk of chronic rejection episodes. Therefore therapeutic drug monitori...Continue Reading

Citations

Mar 18, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Samuel FantaKalle Hoppu
Feb 13, 2013·Clinical Pharmacokinetics·Dorothée FruitAurélie Prémaud
Mar 26, 2004·Transplantation Proceedings·D Abendroth
Mar 26, 2004·Transplantation Proceedings·F Citterio
Mar 26, 2004·Transplantation Proceedings·B D Kahan
Dec 14, 2002·Analytical Biochemistry·Benoît BlanchetAlain Astier
Mar 27, 2001·Transplantation Proceedings·J C Hong, B D Kahan
Dec 26, 2001·Transplantation Proceedings·B D Kahan
Sep 10, 2003·Transplantation Proceedings·M D Aumente RubioC Segura Saint-Gerons
Sep 2, 1998·Transplantation Proceedings·E RovelliG D'Amico
May 20, 1999·Transplantation Proceedings·B D Kahan
Sep 17, 2002·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·C BalramYong Seng Tan
Apr 19, 2000·Clinical Transplantation·B D KahanC T Van Buren
Dec 13, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Gunilla EineckeKlemens Budde
Apr 9, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Guido Filler
Dec 21, 2004·British Journal of Clinical Pharmacology·Hélène BourgoinChantal Le Guellec
May 21, 2005·Drugs & Aging·Johan W de Fijter
Jun 8, 2000·Clinical Pharmacokinetics·R J Dumont, M H Ensom
Jul 4, 2001·Clinical Pharmacokinetics·J DebordP Marquet
Aug 21, 2009·Clinical Pharmacokinetics·Caroline Monchaud, Pierre Marquet
Feb 5, 2008·Pharmacogenomics·Dany AnglicheauEric Thervet
May 17, 2014·Journal of Cardiovascular Translational Research·S J Jansen Of LorkeersS A J Chamuleau
Nov 24, 1999·Clinical Therapeutics·L M ShawR W Yatscoff
Jul 16, 2003·Clinical Therapeutics·Stephen PollardUNKNOWN CONSENT: Consensus on Substitution in European Transplantation
Dec 18, 2015·Journal of Veterinary Pharmacology and Therapeutics·C L FellmanA J Mackin
May 24, 2008·The Annals of Thoracic Surgery·Rogerio PazettiFabio B Jatene
Jun 9, 2004·Clinical Biochemistry·Michael OellerichBurkhard Tönshoff
Aug 4, 2006·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Federico CasaleMauro Salizzoni
Jul 26, 2014·Medicina·Aurelija NoreikaitėEdgaras Stankevičius
Apr 15, 1999·Clinical Transplantation·A N WarrensR I Lechler
Dec 14, 2004·The Annals of Pharmacotherapy·Raymond G Morris

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