Abbreviated kinetic profiles in area-under-the-curve monitoring of cyclosporine therapy. Technical note.

Background: The new microemulsion formulation of cyclosporine (CsA-ME) displays more consistent pharmacokinetic properties than the original formulation and may allow successful implementation of an abbreviated area-under-the-curve (AUC) strategy.

Methods: Here we compared two limited sampling strategies in order to define the one that best predicts AUC after CsA-ME in 51 renal transplant recipients with stable renal function. Pharmacokinetics were based on analysis of blood samples collected over 12 hours after drug administration by high-performance liquid chromatography (HPLC).

How to convert from traditional cyclosporine to the microemulsion formulation in stable renal transplant patients?

How to convert from traditional cyclosporine (CsA) to the microemulsion formulation in stable renal transplant patients is still a matter of debate. The present study was designed to evaluate the effects of changeover from traditional Sandimmune to Neoral formulation at two dose-ratio conversions on CsA pharmacokinetics, safety and tolerability particularly in terms of renal function. Thirty outpatients regularly followed at our Clinical Research Center were randomized to 1:1 or 1:0.

Precision of plasma clearance of iohexol for estimation of GFR in patients with renal disease.

The choice of the optimal method for the measurement of renal function is based on the accuracy and the precision of the technique. The plasma clearance of nonradioactive iohexol has been proposed as a reliable alternative to renal clearance of inulin for estimation of GFR. However, the precision of this method in estimating GFR in patients with renal disease has not been determined so far.

Prediction of cyclosporine area under the curve using a three-point sampling strategy after Neoral administration.

Accurate monitoring of cyclosporine (CsA) dosage is still a problem, because measurement of the area under the curve (AUC)--the most appropriate indicator of exposure to CsA--requires a number of blood samples to be taken over 12 h, which makes monitoring difficult in day-to-day clinical practice. This study investigated whether a limited sampling strategy in human kidney transplantation reflected the actual AUC better in patients given Neoral than in those being treated with Sandimmune. Stepwise multiple regression analysis of CsA blood levels recorded after Neoral administration to 20 renal transplant patients showed the best results in AUC prediction with three sampling points (1.