Publications by authors named "Benedicte Franck"

Background: Therapeutic drug monitoring of infliximab is commonly performed based on trough concentration. However, doses and dosing intervals may be adapted to patient outcomes, and this trough concentration target may correspond to a large range of exposures in terms of the area under the concentration-time curve (AUC). The objectives of this study were to assess the real-life exposure to intravenous infliximab in patients with Crohn disease in remission at year 1 and to assess the evolution of exposure in patients who switched to subcutaneous infliximab.

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Intravenous ganciclovir and oral valganciclovir display significant variability in ganciclovir pharmacokinetics, particularly in children. Therapeutic drug monitoring currently relies on the area under the concentration-time (AUC). Machine-learning (ML) algorithms represent an interesting alternative to Maximum-a-Posteriori Bayesian-estimators for AUC estimation.

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Nirmatrelvir/ritonavir is a protease inhibitor antiviral drug indicated in the treatment of severe acute respiratory syndrome coronavirus-2 infections in high-risk patients for a severe disease. Unfortunately, ritonavir, used to boost nirmatrelvir pharmacokinetics, can also inhibit or induce the metabolism of other co-administered drugs substrates. This may lead to a subsequent risk of adverse drug reaction and lack of efficacy.

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Background And Objectives: Ganciclovir (GCV) and valganciclovir (VGCV) show large interindividual pharmacokinetic variability, particularly in children. The objectives of this study were (1) to develop machine learning (ML) algorithms trained on simulated pharmacokinetics profiles obtained by Monte Carlo simulations to estimate the best ganciclovir or valganciclovir starting dose in children and (2) to compare its performances on real-world profiles to previously published equation derived from literature population pharmacokinetic (POPPK) models achieving about 20% of profiles within the target.

Materials And Methods: The pharmacokinetic parameters of four literature POPPK models in addition to the World Health Organization (WHO) growth curve for children were used in the mrgsolve R package to simulate 10,800 pharmacokinetic profiles.

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Purpose: Therapeutic drug monitoring of tacrolimus using trough concentration (C) is mandatory to ensure drug efficacy and safety in solid organ transplantation. However, C is just a proxy for the area under the curve of drug concentrations (AUC) which is the best pharmacokinetic parameter for exposure evaluation. Some studies suggest that patients may present discrepancies between these two parameters.

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The most appropriate renal function estimation equation to predict drug clearance is a matter of debate. In this study, we compare the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease Epidemiology collaboration (CKD-EPI) and the Cockroft-Gault (CG) equations to predict amoxicillin and cloxacillin clearance among hospitalized patients receiving high doses of these antibiotic treatments. This study aimed to compare different equations used to predict amoxicillin and cloxacillin clearance among hospitalized patients receiving amoxicillin or cloxacillin treatments outside the intensive care unit.

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Article Synopsis
  • This study evaluated the effectiveness of a new plasma quantification method (mAbXmise kit) for infliximab and adalimumab compared to traditional ELISA methods in patients with inflammatory bowel disease.
  • The mAbXmise method used liquid chromatography tandem mass spectrometry (LC-MS/MS) and showed a linear range of 2 to 100 μg/ml, validated according to international standards.
  • Results indicated that the bias in measuring infliximab was significantly higher with commercial ELISA compared to an in-house ELISA, while the bias for adalimumab was smaller, suggesting that LC-MS/MS is a robust alternative for monitoring these medications.
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Ganciclovir and valganciclovir are first choice drugs for the prevention and treatment of cytomegalovirus infection and disease in solid organ and stem cell transplant recipients. Only a few studies on the pharmacokinetics and exposure/efficacy or exposure/safety relationships of ganciclovir and valganciclovir in transplant recipients have been published so far, and there are still controversies about the exposure parameter to use for therapeutic drug monitoring (TDM). We performed an extensive literature review of the clinical pharmacokinetics data, the exposure/effect relationships in terms of efficacy and safety, and the available tools for valganciclovir and ganciclovir TDM in adults and pediatrics transplant recipients.

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Background And Objective: Given a high pharmacokinetic inter-individual variability and a low exposure target achievement, ganciclovir (GCV) therapeutic drug monitoring is sometimes used in children. We aimed to develop and validate Bayesian estimators based on limited sampling strategies for the estimation of GCV area under the concentration-time curve from 0 to 24 h in pediatric transplant recipients treated with valganciclovir (VGCV) or GCV.

Methods: Solid organ transplant or stem-cell transplant recipients who received GCV or VGCV and had available GCV concentrations per standard of care were retrospectively included in this study for pharmacokinetic modeling and development of Bayesian estimators using the iterative two-stage Bayesian method.

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Background: Antimicrobial stewardship is a standard practice in health facilities to reduce both the misuse of antimicrobials and the risk of resistance.

Objective: To determine the profile of antimicrobial use in the pediatric population of a university hospital centre from 2015/16 to 2018/19.

Methods: In this retrospective, descriptive, cross-sectional study, the pharmacy information system was used to determine the number of days of therapy (DOTs) and the defined daily dose (DDD) per 1000 patient-days (PDs) for each antimicrobial and for specified care units in each year of the study period.

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Article Synopsis
  • The study investigates the optimal dosing of Ganciclovir (GCV) and its prodrug Valganciclovir (VGCV) for preventing and treating cytomegalovirus in pediatric transplant recipients, due to significant variability in how children metabolize these drugs.
  • A population pharmacokinetic analysis was conducted with data from 50 pediatric patients, demonstrating that factors like body weight and kidney function significantly affect drug clearance and distribution.
  • Results indicate that the currently recommended doses have low success rates in achieving therapeutic targets, suggesting the need for therapeutic drug monitoring to improve patient outcomes.
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  • The study aimed to create a population pharmacokinetics model for gentamicin specifically for patients undergoing dialysis, focusing on optimal dosing using Monte Carlo simulations to analyze different MIC breakpoints.
  • It involved 23 patients and 141 gentamicin samples, considering factors like weight and dialysis characteristics to develop a fitting model that predicts drug concentration outcomes.
  • Findings suggest that standard gentamicin doses are inadequate for dialysis patients and recommend higher doses (3-8 mg/kg/day) given just before dialysis to effectively treat infections related to specific MIC levels.
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A 67-year-old man was admitted to the emergency department about 5 h after deliberate self-poisoning with 300 mg of Apixaban. The clinical examination did not show any organ dysfunctions or haemorrhagic signs, and the patient's life was not in danger. The first analysis, upon admission, showed a concentration of 2655 μg l of Apixaban.

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