Evaluation of tacrolimus abbreviated area-under-the-curve monitoring in renal transplant patients who are potentially at risk for adverse events.

Clinical Transplantation
Yuen Yi HonRoslyn B Mannon

Abstract

In a cohort of 32 renal transplant patients who are potentially at risk for adverse events, we compared tacrolimus (TAC) abbreviated AUC values calculated by a method developed in Asians (AUCw) with those derived for Caucasians (AUCa). The relationships between TAC trough (C0), abbreviated AUC, and biopsy results were also assessed. Forty-eight AUCs and 15 associated biopsies were evaluated. For AUCs obtained only from Caucasian patients, median AUCw value was lower than that of AUCa (104 vs. 115 ng×h/mL, n=29, p<0.0001). AUCs obtained from the two methods for all patients correlated with C0 (rs>0.72, n=48, p<0.0001). Median AUCw (72.9 vs. 174 ng×h/mL, p=0.043) and AUCa (81.0 vs. 203 ng×h/mL, p=0.043) were lower in patients experiencing biopsy-proven acute rejection (AR) than those with normal histology. C0 tended to be lower in biopsies showing AR>6 months post-transplant (5.80 vs. 11.0 ng/mL, p=0.110). Thus, lower abbreviated AUCs were obtained for Caucasians using a method developed in Asians. C0 correlated well with abbreviated AUCs. Lower C0 and AUC appeared to be associated with biopsy-proven AR>6 months post-transplant. Further prospective evaluation of TAC AUC and C0 monitoring in a larger cohort of patients is warranted.

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Citations

Mar 7, 2014·European Journal of Drug Metabolism and Pharmacokinetics·Radmila Velickovic-RadovanovicTatjana Cvetkovic
Jan 22, 2019·Pediatric Transplantation·Nicholas J A WebbUNKNOWN OPTION Study Group
Nov 13, 2012·PloS One·Takahiro HiguchiKuniyasu Imanaka
Apr 9, 2020·Pharmacy : Journal of Pharmacy, Education and Practice·Jeffrey YinLinda Awdishu
May 28, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Gonzalo N Almeida-PauloAntonio J Carcas-Sansuán
Feb 13, 2020·Transplantation Direct·Emilio CanovaiTim Vanuytsel

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