Relationship between concentration of cyclosporine A and its clinical efficacy after heart transplant / 中国药学杂志

ABSTRACT

OBJECTIVE: To improve the efficacy and safety of cyclosporine A through analysis of the relationship between drug monitoring data and its clinical efficacy after heart transplant (HT). METHODS: Four hundred and fifty-eight blood concentration data from 27 HT patients were retrospectively analyzed. The HT patients were divided into normal, toxic, and rejection group. The cyclosporine A blood concentrations among these three groups were compared. The changes of blood concentrations were discussed in different postoperative periods of HT patients grouped by the occurrence of rejection and toxicity respectively. RESULTS: The trend of cyclosporine A blood concentration change was unpredictable in the early postoperative period. The average ρ0 and ρ2 had significant differences among the three groups. ρ0 had no significant difference in most postoperative periods between toxic group and non-toxic group or rejection group and non-rejection group, however, ρ2 had a significant difference in most postoperative periods and ρ0 was also able to predict the cases of malabsorption, indicating that monitoring ρ2 had more clinical significance than monitoring ρ0. CONCLUSION: Blood concentration monitoring can provide a reference for cyclosporine A usage in the clinical practice. For HT patients, ρ2 is more scientific and sensitive than ρ0 as a monitoring index in both preventing acute rejection and toxicity and adjusting dosage. Cyclosporine A blood concentration monitoring should be closely combined with clinical practice to individualize its use and thus achieve a satisfactory immunosuppressive effect.