CYCLOSPORINE PLASMA-LEVELS 6 HOURS AFTER ORAL-ADMINISTRATION - A USEFUL TOOL FOR MONITORING THERAPY
CYCLOSPORINE PLASMA-LEVELS 6 HOURS AFTER ORAL-ADMINISTRATION - A USEFUL TOOL FOR MONITORING THERAPY
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DOI：
10.1097/00007890-198802000-00029
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发表时间：
1988-02-01
期刊：
影响因子：
6.2
通讯作者：
TRAEGER, J
中科院分区：
文献类型：
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作者：
CANTAROVICH, F;BIZOLLON, C;TRAEGER, J
回顾性分析了65例接受CsA治疗的移植患者（55例肾，10例肾和胰腺）的临床演变和CsA监测（45例）和前瞻性（34例）。结果表明：（1）即使CsA血药谷浓度较低，肾毒性也不少见;（2）CsA药代动力学血浆曲线的T6值（口服药物给药后6小时）是完整药代动力学研究的有效表达;（3）当T6被前瞻性地用作监测工具并且不考虑伴随的血清肌酸酐水平而进行剂量调整时，当调整CsA剂量以纠正毒性（> 350 ng/ml）或亚治疗（< 100 ng/ml）T6时，后者降低，P < 0.01。目前，我们所有患者的血清肌酐为180.2 ±。8 μ mol/L，并且没有患者需要转换到常规治疗。CsA口服给药每日一次或两次的患者血浆谷浓度的有效性似乎值得怀疑，T6被证明更有用。因此，可以避免肾毒性和CsA治疗不足。这种新的监测工具（T6）将允许使用较低剂量的CsA，从而有助于改善长期移植功能。
Clinical evolution and cyclosporine (CsA) monitoring of 65 transplanted patients (55 kidneys, and 10 kidneys and pancreases) treated with CsA were analyzed retrospectively (45 patients) and prospectively (34 patients). Our results showed the following: (1) nephrotoxicity is not uncommon even with low trough plasma levels of CsA; (2) the T6 value of a CsA pharmacokinetic plasma curve (6 hr after oral drug administration) is a valid expression of a full pharmacokinetic study; (3) when T6 was used prospectively as a monitoring tool and dose adjustments made disregarding concomitant serum creatinine levels, the latter decreased when CsA dose adjustments were made to correct toxic (> 350 ng/ml) or subtherapeutic (< 100 ng/ml) T6, P < 0.01. At present, serum creatinine for all our patients is 180.2 .+-. 8 .mu.mol/L, and no patient has needed to be switched to conventional treatment. The validity of trough plasma levels in patients under CsA oral administration once or twice a day seems questionable, and T6 proved to be more useful. Thus nephrotoxicity and CsA undertreatment may be avoided. This new monitoring tool (T6) will allow the utilization of lower doses of CsA and thus contribute to improved long-term graft function.