Time-dependent changes in cyclosporine exposure: implications for achieving target concentrations

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dc.contributor.author Felipe, Claudia Rosso [UNIFESP]
dc.contributor.author Tedesco-Silva, Hélio [UNIFESP]
dc.contributor.author Machado, Paula Goulart Pinheiro [UNIFESP]
dc.contributor.author Garcia, Riberto [UNIFESP]
dc.contributor.author Moreira, Silvia Regina da Silva [UNIFESP]
dc.contributor.author Medina-Pestana, José Osmar [UNIFESP]
dc.date.accessioned 2016-01-24T12:33:55Z
dc.date.available 2016-01-24T12:33:55Z
dc.date.issued 2003-07-01
dc.identifier http://dx.doi.org/10.1111/j.1432-2277.2003.tb00338.x
dc.identifier.citation Transplant International. New York: Springer-verlag, v. 16, n. 7, p. 494-503, 2003.
dc.identifier.issn 0934-0874
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/27293
dc.description.abstract This study analyzed early changes in trough blood cyclosporine concentrations and cyclosporine exposures after kidney transplantation. Seventy-two patients who received cyclosporine-based immunosuppressive therapy were intensively monitored (CO) during the first 6 months after transplantation. Full pharmacokinetic studies were performed at day 4, and months 2, 3, and 6 after transplantation. Mean steady-state, dose-adjusted trough cyclosporine blood concentrations increased from 1.1+/-0.60 (day 7) to 2.0+/-1.20 ng/ml per mg (day 30, P<0.01). Steady-state, dose-adjusted cyclosporine exposure parameters (C0, Cmax, AUC, Cavg, and C12) were significantly lower at day 4 than at months 2, 3, and 6 after transplantation (P<0.01). Initial cyclosporine doses produced target concentrations in only 30% of the patients at day 3. C2 was the single concentration that showed high and consistent correlation with serial AUC measurements (r(2)greater than or equal to0.76). the incidence of biopsy-proven acute rejection was 20.5% and was not associated with ethnicity, HLA mismatch, adjunctive therapy, or blood trough cyclosporine concentrations below 200 ng/ml at day 3. Significant time-dependent increases in steady-state cyclosporine exposure occur during the first month after kidney transplantation. Due to the low relative bioavailability early after surgery, higher doses and more frequent cyclosporine dose adjustments are necessary to produce target exposures early after transplantation. en
dc.format.extent 494-503
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Transplant International
dc.rights Acesso aberto
dc.subject kidney transplantation en
dc.subject cyclosporine en
dc.subject pharmacokinetics en
dc.subject therapeutic drug monitoring en
dc.title Time-dependent changes in cyclosporine exposure: implications for achieving target concentrations en
dc.type Artigo
dc.rights.license http://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Universidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.identifier.doi 10.1007/s00147-003-0573-7
dc.description.source Web of Science
dc.identifier.wos WOS:000184854200007



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