Abbreviated kinetic profiles in area-under-the-curve monitoring of cyclosporine therapy: Technical note

Flavio Gaspari, Norberto Perico, Orietta Signorini, Raffaele Caruso, Giuseppe Remuzzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The new microemulsion formulation of cyclosporine (CsA-ME) displays more consistent pharmacokinetic properties than the original formulation and may allow successful implementation of an abbreviated area- under-the-curve (AUC) strategy. Methods. Here we compared two limited sampling strategies in order to define the one that best predicts AUC after CsA-ME in 51 renal transplant recipients with stable renal function. Pharmacokinetics were based on analysis of blood samples collected over 12 hours after drug administration by high-performance liquid chromatography (HPLC). Predicted AUC was estimated by using a three-point (0, 1 and 3 hr) or a two-point (2 and 6 hr or 0 and 2 hr) sampling strategy. Results. A simplified strategy with three time points of blood collection at 0, 1, and 3 hours after CsA-ME allowed adequate and accurate prediction of the daily exposure to CsA. AUC prediction with two-point sampling at 2 and 6 hours was less good with a very large error in prediction (only 59% of the estimated AUC were within the accepted range). This limitation was even more evident when the 0 and 2 hour time points were examined, in which only 51% of AUC estimates were included in the accepted range of variation (-10 to 10%). Conclusions. A limited strategy of three-point sampling taken early after dosing allows an excellent and perfectly reliable prediction of the actual AUC.

Original languageEnglish
Pages (from-to)2146-2150
Number of pages5
JournalKidney International
Volume54
Issue number6
DOIs
Publication statusPublished - 1998

Keywords

  • AUC
  • Graft survival
  • Immunosuppression
  • Pharmacokinetic profile
  • Stepwise regression analysis

ASJC Scopus subject areas

  • Nephrology

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