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A Double Absorption-Phase Model Adequately Describes Mycophenolic Acid Plasma Profiles inDe NovoRenal Transplant Recipients Given Oral Mycophenolate Mofetil

 

作者: Aurélie Prémaud,   Jean Debord,   Annick Rousseau,   Yannick Le Meur,   Olivier Toupance,   Yvon Lebranchu,   Guillaume Hoizey,   Chantal Le Guellec,   Pierre Marquet,  

 

期刊: Clinical Pharmacokinetics  (ADIS Available online 2005)
卷期: Volume 44, issue 8  

页码: 837-847

 

ISSN:0312-5963

 

年代: 2005

 

出版商: ADIS

 

关键词: Immunosuppressants, pharmacokinetics;Mycophenolate mofetil, pharmacokinetics;Mycophenolic acid, pharmacokinetics;Pharmacokinetic modelling;Renal transplant

 

数据来源: ADIS

 

摘要:

BackgroundMycophenolic acid (MPA) shows complex plasma concentration-time profiles, particularly in the immediate (first month) post-transplantation phase for which no relevant pharmacokinetic model has been proposed thus far.ObjectiveThe aim of this study was to develop a model to accurately describe the time profile of plasma MPA concentrations after oral administration of mycophenolate mofetil in adult kidney transplant patients, in any post-transplantation period.MethodFull interdose pharmacokinetic profiles were collected in 45 adult renal transplant patients who were orally administered mycophenolate mofetil and ciclosporin; 25 patients werede novotransplant patients for whom individual pharmacokinetics were assessed at three post-transplantation periods (days 3, 7 and 30) and 20 patients were stable transplant patients (>3 months post-transplantation). MPA was determined in plasma by liquid chromatography-mass spectrometry. Models combining a single- or double-input (described as single or double gamma distributions) with one- or two-compartments were developed using in-house software and fitted to the individual profiles by nonlinear regression.ResultsVisual inspection of the pharmacokinetic profiles showed highly variable absorption profiles and secondary peaks of various intensity. The pharmacokinetic models including a double gamma distribution best fitted these various profiles in the immediate post-transplantation period (mean bias and precision of −0.92% and 20.19%; −1.5% and 18.02%, on day 7 and day 30, respectively), while in the stable post-grafting phase (beyond 3 months), the single- and double-absorption models performed similarly (mean bias and precision of −3.37% and 17.64%; −3.12% and 18.44%, on day 7 and day 30, respectively).ConclusionThe proposed pharmacokinetic models adequately describe the concentration-time profiles of MPA in renal transplant patients and could be helpful in the development of tools for MPA monitoring.

 

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