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Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients

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Authors
Golubović, Bojana
Prostran, Milica
Miljković, Branislava
Vučićević, Katarina
Radivojević, Dragana
Grabnar, Iztok
Article (Published version)
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Abstract
Immunosuppressive therapy is the cornerstone of successful kidney transplantation. Frequently used immunosuppressives are cyclosporine, tacrolimus, sirolimus and mycophenolic acid. These drugs have narrow therapeutic index and show high pharmacokinetic variability. In order to maintain the balance between efficacy and safety, dosing is based on measured drug concentrations. Proper identification, quantification and understanding the sources of variability in measured concentrations facilitate routine dose adjustment in clinical practice. Classical pharmacokinetic studies have limited use in transplant patients attributable to design with intense sampling in a small, relatively homogenous population, and identification of only single variability factor per study. Population approach is a powerful tool for analysing sparse data, identifying factors that influence drug pharmacokinetics and estimating variability. In this report we reviewed available population pharmacokinetic models for c...yclosporine, tacrolimus, sirolimus and mycophenolic acid in adult kidney transplant patients. The major focus was to describe various demographic factors, biochemical parameters, genetic polymorphisms of metabolic enzymes and transporters and drug-drug interactions, which have been identified as an important concern of pharmacokinetic variability in kidney transplant patients.

Source:
Current Medicinal Chemistry, 2016, 23, 19, 1998-2011
Publisher:
  • Bentham Science Publ Ltd, Sharjah
Funding / projects:
  • Basic and Clinical Pharmacological research of mechanisms of action and drug interactions in nervous and cardiovascular system (RS-175023)

DOI: 10.2174/0929867323666151221150214

ISSN: 0929-8673

PubMed: 26687831

WoS: 000380786400006

Scopus: 2-s2.0-84981343926
[ Google Scholar ]
9
8
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/2678
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Golubović, Bojana
AU  - Prostran, Milica
AU  - Miljković, Branislava
AU  - Vučićević, Katarina
AU  - Radivojević, Dragana
AU  - Grabnar, Iztok
PY  - 2016
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2678
AB  - Immunosuppressive therapy is the cornerstone of successful kidney transplantation. Frequently used immunosuppressives are cyclosporine, tacrolimus, sirolimus and mycophenolic acid. These drugs have narrow therapeutic index and show high pharmacokinetic variability. In order to maintain the balance between efficacy and safety, dosing is based on measured drug concentrations. Proper identification, quantification and understanding the sources of variability in measured concentrations facilitate routine dose adjustment in clinical practice. Classical pharmacokinetic studies have limited use in transplant patients attributable to design with intense sampling in a small, relatively homogenous population, and identification of only single variability factor per study. Population approach is a powerful tool for analysing sparse data, identifying factors that influence drug pharmacokinetics and estimating variability. In this report we reviewed available population pharmacokinetic models for cyclosporine, tacrolimus, sirolimus and mycophenolic acid in adult kidney transplant patients. The major focus was to describe various demographic factors, biochemical parameters, genetic polymorphisms of metabolic enzymes and transporters and drug-drug interactions, which have been identified as an important concern of pharmacokinetic variability in kidney transplant patients.
PB  - Bentham Science Publ Ltd, Sharjah
T2  - Current Medicinal Chemistry
T1  - Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients
VL  - 23
IS  - 19
SP  - 1998
EP  - 2011
DO  - 10.2174/0929867323666151221150214
ER  - 
@article{
author = "Golubović, Bojana and Prostran, Milica and Miljković, Branislava and Vučićević, Katarina and Radivojević, Dragana and Grabnar, Iztok",
year = "2016",
abstract = "Immunosuppressive therapy is the cornerstone of successful kidney transplantation. Frequently used immunosuppressives are cyclosporine, tacrolimus, sirolimus and mycophenolic acid. These drugs have narrow therapeutic index and show high pharmacokinetic variability. In order to maintain the balance between efficacy and safety, dosing is based on measured drug concentrations. Proper identification, quantification and understanding the sources of variability in measured concentrations facilitate routine dose adjustment in clinical practice. Classical pharmacokinetic studies have limited use in transplant patients attributable to design with intense sampling in a small, relatively homogenous population, and identification of only single variability factor per study. Population approach is a powerful tool for analysing sparse data, identifying factors that influence drug pharmacokinetics and estimating variability. In this report we reviewed available population pharmacokinetic models for cyclosporine, tacrolimus, sirolimus and mycophenolic acid in adult kidney transplant patients. The major focus was to describe various demographic factors, biochemical parameters, genetic polymorphisms of metabolic enzymes and transporters and drug-drug interactions, which have been identified as an important concern of pharmacokinetic variability in kidney transplant patients.",
publisher = "Bentham Science Publ Ltd, Sharjah",
journal = "Current Medicinal Chemistry",
title = "Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients",
volume = "23",
number = "19",
pages = "1998-2011",
doi = "10.2174/0929867323666151221150214"
}
Golubović, B., Prostran, M., Miljković, B., Vučićević, K., Radivojević, D.,& Grabnar, I.. (2016). Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients. in Current Medicinal Chemistry
Bentham Science Publ Ltd, Sharjah., 23(19), 1998-2011.
https://doi.org/10.2174/0929867323666151221150214
Golubović B, Prostran M, Miljković B, Vučićević K, Radivojević D, Grabnar I. Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients. in Current Medicinal Chemistry. 2016;23(19):1998-2011.
doi:10.2174/0929867323666151221150214 .
Golubović, Bojana, Prostran, Milica, Miljković, Branislava, Vučićević, Katarina, Radivojević, Dragana, Grabnar, Iztok, "Population Pharmacokinetic Approach of Immunosuppressive Therapy in Kidney Transplant Patients" in Current Medicinal Chemistry, 23, no. 19 (2016):1998-2011,
https://doi.org/10.2174/0929867323666151221150214 . .

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