A six-hour extrapolated sampling strategy for monitoring mycophenolic acid in renal transplant patients in the Indian subcontinent.
J Postgrad Med
;
2006 Oct-Dec; 52(4): 248-52
Article
in English
| IMSEAR
| ID: sea-115574
ABSTRACT
BACKGROUND:
Therapeutic drug monitoring for mycophenolic acid (MPA) is increasingly being advocated. The present therapeutic range relates to the 12-hour area under the serum concentration time profile (AUC).However, this is a cumbersome, tedious, cost restricting procedure. Is it possible to reduce this sampling period?AIM:
To compare the AUC from a reduced sampling strategy with the full 12-hour profile for MPA. SETTINGS ANDDESIGN:
Clinical Pharmacology Unit of a tertiary care hospital in South India. Retrospective, paired data. MATERIALS ANDMETHODS:
Thirty-four 12-hour profiles from post-renal transplant patients on Cellcept were evaluated. Profiles were grouped according to steroid and immunosuppressant co-medication and the time after transplant. MPA was estimated by high performance liquid chromatography with UV detection. From the 12-hour profiles the AUC up to only six hours was calculated by the trapezoidal rule and a correction factor applied. These two AUCs were then compared. STATISTICALANALYSIS:
Linear regression, intra-class correlations (ICC) and a two-tailed paired t-test were applied to the data.RESULTS:
Comparing the 12-hour AUC with the paired 6-hour extrapolated AUC, the ICC and linear regression(r2) were very good for all three groups. No statistical difference was found by a two-tailed paired t-test. No bias was seen with a Bland Altman plot or by calculation.CONCLUSION:
For patients on Cellcept with prednisolone +/- cyclosporine the 6-hour corrected is an accurate measure of the full 12-hour AUC.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Time Factors
/
Humans
/
Adolescent
/
Kidney Transplantation
/
Drug Monitoring
/
Adult
/
Area Under Curve
/
Immunosuppressive Agents
/
India
/
Middle Aged
Type of study:
Prognostic study
Country/Region as subject:
Asia
Language:
English
Journal:
J Postgrad Med
Year:
2006
Type:
Article
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