Bibliographic Details
| Title: |
Tacrolimus Dose Requirement in De Novo Adult Kidney Transplant Patients Treated With Adoport® Can Be Anticipated |
| Authors: |
Pierre Marquet, Dany Anglicheau, Antoine Humeau, Sofian Adrouche, Lakhdar Saada, Julie Bisiaux, Sara Guillemin, Audrey Lardy-Cléaud, Lionel Rostaing |
| Source: |
Transplant International, Vol 37 (2024) |
| Publisher Information: |
Frontiers Media S.A., 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Specialties of internal medicine |
| Subject Terms: |
tacrolimus, pharmacokinetic variability, diet, ethnicity, genetic polymorphisms, Specialties of internal medicine, RC581-951 |
| More Details: |
All the factors potentially influencing tacrolimus dose requirement and combinations thereof have never been thoroughly investigated, precluding accurate prediction of tacrolimus starting dose. This prospective, non-interventional, multicenter study in de novo adult kidney transplant recipients over the first year after transplantation aimed to investigate the factors influencing tacrolimus dose-standardized trough blood concentration (C0/D) over the first week post-transplant (D4-D7, primary objective), D8-M3 and M3-M12 (secondary objectives). Statistical analysis employed mixed linear models with repeated measures. Eighteen sites enrolled 440 patients and followed them up for 9.5 ± 4.1 months. Age at baseline (p = 0.0144), end-stage renal disease (p = 0.0092), CYP3A phenotype (p < 0.0001), dyslipidemia at baseline (p = 0.0031), hematocrit (p = 0.0026), total bilirubin (p = 0.0261) and plasma creatinine (p = 0.0484) independently increased with log(C0/D) over D4-D7, explaining together 72.3% of the interindividual variability, and representing a robust model to estimate tacrolimus initial dose. Donor age and CYP3A phenotype were also influential over D8-M3 and M3-12, in addition to recipient age. Corticosteroids, diabetes at baseline, and ASAT yielded inconstant results between D8-M3 and M3-M12. We found no ethnicity effect when CYP3A phenotype was accounted for, and no food effect. Intra-individual variability over M3-M12 was moderate, and significantly lower in patients with chronic hepatic disorder (p = 0.0196) or cancer (p = 0.0132). |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1432-2277 |
| Relation: |
https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13495/full; https://doaj.org/toc/1432-2277 |
| DOI: |
10.3389/ti.2024.13495 |
| Access URL: |
https://doaj.org/article/4ed9a91435b44ababa90035d64d19c85 |
| Accession Number: |
edsdoj.4ed9a91435b44ababa90035d64d19c85 |
| Database: |
Directory of Open Access Journals |
