Therapeutic Monitoring of Calcineurin Inhibitors for the Nephrologist
TLDR
The purpose of this article is to review the current understanding of CNI pharmacokinetics and its relevance to proper dosing and monitoring of these medications and discusses the effect of adjunctive immunosuppressive agents on CNI Pharmacokinetic and dosing.Abstract:
The calcineurin inhibitors (CNI) cyclosporine and tacrolimus remain the backbone of immunosuppression for most kidney transplant recipients. Despite many years of experience, protocols that optimize efficacy with minimal toxicity remain a subject of debate. Nevertheless, studies of the pharmacokinetic properties of the CNI, particularly cyclosporine, have led to improved dosing strategies. The purpose of this article is to review the current understanding of CNI pharmacokinetics and its relevance to proper dosing and monitoring of these medications. This article also reviews the trials that have helped to define the optimal dosages and discusses the effect of adjunctive immunosuppressive agents on CNI pharmacokinetics and dosing.read more
Citations
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Journal ArticleDOI
CYP3A4∗18B and CYP3A5∗3 polymorphisms contribute to pharmacokinetic variability of cyclosporine among healthy Chinese subjects.
Xing-ru Tao,Xiu-yuan Xia,Jing Zhang,Lian-ying Tong,Wei Zhang,Xin Zhou,Zhihong Liu,Hongtao Song +7 more
TL;DR: The results indicate that gender and polymorphism in CYP3A4∗18B and CYP 3A5∗3 significantly affect cyclosporine pharmacokinetics in healthy subjects.
Découverte de nouveaux marqueurs pharmacogénomiques de la maladie du greffon contre l'hôte en transplantation de cellules souches hématopoïétiques
TL;DR: In this article, the authors propose a method to solve the problem of "uniformity" and "uncertainty" in the context of online learning, and propose a solution.
Journal ArticleDOI
Cyclosporin A: A Repurposable Drug in the Treatment of COVID-19?
Christian Devaux,Cléa Melenotte,Marie-Dominique Piercecchi-Marti,Marie-Dominique Piercecchi-Marti,Clémence Delteil,Clémence Delteil,Didier Raoult +6 more
TL;DR: In this article, the authors review the molecular mechanisms of action of cyclosporin A in order to highlight why this molecule seems to be an interesting candidate for the therapeutic management of COVID-19 patients.
Journal ArticleDOI
Cinacalcet does not affect the activity of cytochrome P450 3A enzymes, a metabolic pathway for common immunosuppressive agents : a randomized, open-label, crossover, single-centre study in healthy volunteers.
TL;DR: It is suggested that cinacalcet administration does not affect CYP3A activity, and thus would not have an effect on any drug eliminated via CYP2A, including some commonly used immunosuppressant therapies.
Journal ArticleDOI
Tacrolimus Bayesian Dose Adjustment in Pediatric Renal Transplant Recipients.
Pierre Marquet,Florine Cros,Ludovic Micallef,Evelyne Jacqz-Aigrain,Jean-Baptiste Woillard,Caroline Monchaud,Franck Saint-Marcoux,Jean Debord +7 more
TL;DR: The ISBA efficiently reduced tacrolimus under- and overexposure, and the AUC0-12h target ranges for pediatric patients derived from the database were similar to those previously reported for adults.
References
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Journal ArticleDOI
Cyclosporine-associated chronic nephropathy
TL;DR: It is concluded that long-term cyclosporine therapy may lead to irreversible and potentially progressive nephropathy and should be used with restraint and caution until ways are found to mitigate its nephrotoxicity.
Journal ArticleDOI
A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group
TL;DR: Tacrolimus is more effective than cyclosporine in preventing acute rejection in cadaveric renal allograft recipients, and significantly reduces the use of antilymphocyte antibody preparations.
Journal ArticleDOI
Cyclosporin a initially as the only immunosuppressant in 34 recipients of cadaveric organs: 32 kidneys, 2 pancreases, and 2 livers
R.Y. Calne,Keith Rolles,Sathia Thiru,McMaster P,G.N. Craddock,S. Aziz,D.J.G. White,D. B. Evans,D.C Dunn,R.G. Henderson,P. Lewis +10 more
TL;DR: 34 patients treated with cyclosporin A received 36 cadaveric organ allografts, 26 kidneys are still supporting life, 3 after more than a year; the pancreases and livers are also functioning.
Journal ArticleDOI
Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: a randomised multicentre study
TL;DR: Use of sirolimus reduced occurrence and severity of biopsy-confirmed acute rejection episodes with no increase in complications and further studies are needed to establish the optimum doses for the combined regimen.
Journal ArticleDOI
Multicenter randomized trial comparing tacrolimus (FK506) and cyclosporine in the prevention of renal allograft rejection - A report of the European Tacrolimus Multicenter Renal Study Group
AD Mayer,Jean-Paul Squifflet +1 more
TL;DR: A significant reduction in the incidence of episodes of allograft rejection observed with tacrolimus therapy may have important long-term implications given the prognostic influence of rejection on graft survival.
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