Neoral C<sub>2</sub>
 monitoring in maintenance liver transplant patients: A step forward?

Levy, Gary; Cole, Edward

doi:10.1002/lt.20070

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Our data demonstrated that in stable liver transplant patients trough level monitoring frequently leads to overdosing of CYCLO, while monitoring by C‐2 may cause episodes of underdosing 15 . According to Levy and Cole the long‐term benefits of reduced toxicity caused by C‐2 monitoring might well outweigh the development of mild, easily treated rejection 32 . However, it may be better to try to avoid these rejections as well as toxicity.…”

Section: Discussionmentioning

confidence: 72%

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Langers¹,

Cremers²,

Hartigh³

et al. 2005

Aliment Pharmacol Ther

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SUMMARYBackground: New methods to estimate the systemic exposure to ciclosporin such as the level 2 h after dosing and limited sampling formulas may lead to improved clinical outcome after orthotopic liver transplantation. However, most strategies are characterized by rigid sampling times. Aim: To develop and validate a flexible individualized population-pharmacokinetic model for ciclosporin monitoring in orthotopic liver transplantation. Methods: A total of 62 curves obtained from 31 patients at least 0.5 year after orthotopic liver transplantation were divided into two equal groups. From 31 curves, relatively simple limited sampling formulas were derived using multiple regression analysis, while using pharmacokinetic software a two-compartment populationpharmacokinetic model was derived from these same data. We then tested the ability to estimate the AUC by the limited sampling formulas and a different approach using several limited sampling strategies on the other 31 curves. The new approach consists of individualizing the mean a priori population-pharmacokinetic parameters of the two-compartment population-pharmacokinetic model by means of maximum a posteriori Bayesian fitting with individual data leading to an individualized population-pharmacokinetic limited sampling model. From the individualized pharmacokinetic parameters, AUC 0-12h was calculated for each combination of

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Section: Discussionmentioning

confidence: 72%

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Langers¹,

Cremers²,

Hartigh³

et al. 2005

Aliment Pharmacol Ther

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“…Adverse events and acute rejection episodes were similar between treatment groups. Levy et al (8) converted a series of 68 maintenance liver transplant patients from twice-daily to once-daily dosing. The mean cyclosporine C2 level on twice-daily dosing was 648 ng/mL and after conversion to once-daily dosing with dose adjustment was 748 ng/mL.…”

mentioning

confidence: 99%

Cyclosporine pharmacokinetics and blood pressure responses after conversion to once‐daily dosing in maintenance liver transplant patients

Kovarik

Villamil²,

Otero

et al. 2007

Clinical Transplantation

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In this six-month randomized multicenter trial, we characterized cyclosporine pharmacokinetics and blood pressure profiles in maintenance liver transplant patients converting from twice-daily to once-daily cyclosporine dosing. A total of 60 patients were randomized as follows: group A (n = 14) maintained twice-daily dosing; group B (n = 24) converted to once-daily dosing at the same total daily dose as pre-conversion; and group C (n = 22) was treated the same as group B but with a 25% reduction in dose and C2 at two to three wk post-conversion. After conversion to once-daily dosing in groups B and C, trough blood levels (C0) did not change; whereas, C2 nearly doubled. The total daily area under the concentration-time curve AUC(0-24) increased by 29%. After the dose reduction in group C, the AUC(0-24) was similar to the pre-conversion value. Hence, a 25-30% dose reduction can be considered after conversion to once-daily dosing. In the study observation period in weeks 4-15, the median (25-75 percentile) C2 was 568 (469-750) ng/mL for group A; 1055 (840-1224) ng/mL for group B; and 764 (575-959) ng/mL for group C. Conversion to once-daily dosing was associated with a decrease in nighttime mean arterial blood pressure.

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Mycophenolate Mofetil for Renal Dysfunction after Pediatric Liver Transplantation

2005

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In 92% children with renal dysfunction after OLT, MMF treatment provided safe and effective immunosuppression and allowed CsA or Tac to be discontinued or reduced, leading to improvement of renal function. The improvement was greatest in younger children and those who began MMF early postOLT. Side effects were uncommon. Additional steroid cover during the transfer to MMF should be considered to prevent liver-allograft rejection.

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Neoral C₂ monitoring in maintenance liver transplant patients: A step forward?

Cited by 3 publications

References 23 publications

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Cyclosporine pharmacokinetics and blood pressure responses after conversion to once‐daily dosing in maintenance liver transplant patients

Mycophenolate Mofetil for Renal Dysfunction after Pediatric Liver Transplantation

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Neoral C2 monitoring in maintenance liver transplant patients: A step forward?

Cited by 3 publications

References 23 publications

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Easy‐to‐use, accurate and flexible individualized Bayesian limited sampling method without fixed time points for ciclosporin monitoring after liver transplantation

Cyclosporine pharmacokinetics and blood pressure responses after conversion to once‐daily dosing in maintenance liver transplant patients

Mycophenolate Mofetil for Renal Dysfunction after Pediatric Liver Transplantation

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Neoral C₂ monitoring in maintenance liver transplant patients: A step forward?