Tacrolimus population pharmacokinetics in adult heart transplant patients.


Journal

British journal of clinical pharmacology
ISSN: 1365-2125
Titre abrégé: Br J Clin Pharmacol
Pays: England
ID NLM: 7503323

Informations de publication

Date de publication:
Dec 2023
Historique:
revised: 13 07 2023
received: 09 12 2022
accepted: 14 07 2023
medline: 27 11 2023
pubmed: 21 7 2023
entrez: 21 7 2023
Statut: ppublish

Résumé

Tacrolimus is an immunosuppressant largely used in heart transplantation. However, the calculation of its exposure based on the area under the curve (AUC) requires the use of a population pharmacokinetic (PK) model. The aims of this work were (i) to develop a population PK model for tacrolimus in heart transplant patients, (ii) to derive a maximum a posteriori Bayesian estimator (MAP-BE) based on a limited sampling strategy (LSS) and (iii) to estimate probabilities of target attainment (PTAs) for AUC and trough concentration (C0). Forty-seven PK profiles (546 concentrations) of 18 heart transplant patients of the Pharmacocinétique des Immunosuppresseurs chez les patients GREffés Cardiaques study receiving tacrolimus (Prograf®) were included. The database was split into a development (80%) and a validation (20%) set. PK parameters were estimated in MONOLIX® and based on this model a Bayesian estimator using an LSS was built. Simulations were performed to calculate the PTA for AUC and C0. The best model to describe the tacrolimus PK was a two-compartment model with a transit absorption and a linear elimination. Only the CYP3A5 covariate was kept in the final model. The derived MAP-BE based on the LSS (0-1-2 h postdose) yielded an AUC bias ± SD = 2.7 ± 10.2% and an imprecision of 9.9% in comparison to the reference AUC calculated using the trapezoidal rule. PTAs based on AUC or C0 allowed new recommendations to be proposed for starting doses (0.11 mg·kg The MAP-BE developed should facilitate estimation of tacrolimus AUC in heart transplant patients.

Identifiants

pubmed: 37477064
doi: 10.1111/bcp.15857
doi:

Substances chimiques

Tacrolimus WM0HAQ4WNM
Cytochrome P-450 CYP3A EC 1.14.14.1
Immunosuppressive Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3584-3595

Informations de copyright

© 2023 British Pharmacological Society.

Références

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Auteurs

Adrien Paschier (A)

Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, Limoges, France.

Alexandre Destere (A)

Department of Pharmacology and Toxicology, University Hospital of Nice, Nice, France.
Pharmacology & Transplantation, INSERM U1248, Université de Limoges, Limoges, France.
Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France.

Caroline Monchaud (C)

Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, Limoges, France.
Pharmacology & Transplantation, INSERM U1248, Université de Limoges, Limoges, France.

Marc Labriffe (M)

Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, Limoges, France.
Pharmacology & Transplantation, INSERM U1248, Université de Limoges, Limoges, France.

Pierre Marquet (P)

Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, Limoges, France.
Pharmacology & Transplantation, INSERM U1248, Université de Limoges, Limoges, France.

Jean-Baptiste Woillard (JB)

Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, Limoges, France.
Pharmacology & Transplantation, INSERM U1248, Université de Limoges, Limoges, France.

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