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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Effects of immunosuppressive drugs on human adipose tissue metabolism
TL;DR: This paper aims to demonstrate the efforts towards in-situ applicability of EMMARM, as to provide real-time information about the EMT treatment of central nervous system disorders.
Journal ArticleDOI
De novo sirolimus-based regimen in Thai renal transplant recipients.
Natavudh Townamchai,Yingyos Avihingsanon,Kearkiat Praditpornsilpa,Kriang Tungsanga,Somchai Eiam-Ong +4 more
TL;DR: De novo SRL-based regimen with CNI minimization provides excellent transplant outcomes and the strategy to minimize or withdraw CNIs may achieve excellent graft function.
Dissertation
Relationships of Selected CYP and ABCB1 Single Nucleotide Polymorphisms and Patient Characteristics with the Pharmacokinetics of Twice Daily Tacrolimus and Advagraf® in Renal Transplant Recipients
TL;DR: High within-patient variability (WPV) in tacrolimus exposure is considered as a risk factor for allograft loss and late acute rejection (Wu, et al. 2011).The causes of this variability are not completely understood.
Journal ArticleDOI
SARS-CoV-2 and Tacrolimus Blood Concentration in Kidney Transplant Recipients.
Journal ArticleDOI
Monitoring of C0 and C2 Blood Concentrations of Cyclosporine on the Roche Hitachi 902 Analyzer
L. Yargui,A. Berhoune +1 more
TL;DR: The proposed, validated protocol enhanced the versatility of the Emit assay for routine therapeutic drug monitoring by providing parameters to perform the widely used enzyme multiplied immunoassay technique (Emit) cyclosporine assay on a Hitachi 902 analyzer.
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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