Publications by authors named "D J A R Moes"
Voclosporin is a potent immunosuppressive agent currently approved for treating active lupus nephritis. Based on its potential antiviral activity, it has also been investigated as immunosuppressive agent in an investigator-initiated study in SARS-CoV2 positive kidney transplant recipients. As with many immunosuppressive agents, optimizing dosing regimens to achieve therapeutic efficacy while minimizing toxicity remains a critical challenge in clinical practice.
View Article and Find Full Text PDFBackground And Objective: Vancomycin is a glycopeptide antibiotic used for the treatment of severe gram-positive infections. Despite decades of clinical experience, optimized dosing for vancomycin in pediatric populations still warrants further investigation. Patients admitted to the pediatric intensive care unit (PICU) after cardiac surgery are often treated with vancomycin in case of (suspected) infection.
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- High-dose methotrexate (HD-MTX) is commonly used to treat patients with central nervous system lymphoma, but it carries risks of unpredictable toxicity and pharmacokinetic variability.
- The study aimed to characterize the population pharmacokinetics of HD-MTX and identify predictors for the risk of kidney and liver damage.
- Results indicated that factors like estimated glomerular filtration rate (eGFR), treatment regimen, and MTX dose significantly impact PK variability and toxicity risk, with specific concentration thresholds linked to increased chances of nephrotoxicity.
Article Synopsis
- BK polyomavirus-associated nephropathy (BKPyVAN) is a significant complication after kidney transplantation, usually managed by reducing immunosuppression when BK polyomavirus (BKPyV) is detected.
- A study involving 1,076 kidney transplant recipients found a higher risk of developing de novo donor-specific antibodies (dnDSA) in patients with high BKPyV DNA loads compared to those without, suggesting that the required immunosuppression reduction can worsen immune responses.
- While high BKPyV DNAemia increased dnDSA risk, there was no significant difference in the occurrence of biopsy-proven acute rejection (BPAR) between groups, indicating a need for better strategies to manage BKPyV infections in transplant patients.
The Immunosuppressive Drugs Scientific Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology established the second consensus report to guide Therapeutic Drug Monitoring (TDM) of everolimus (EVR) and its optimal use in clinical practice 7 years after the first version was published in 2016. This version provides information focused on new developments that have arisen in the last 7 years. For the general aspects of the pharmacology and TDM of EVR that have retained their relevance, readers can refer to the 2016 document.
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