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High intra‐individual variability of cyclosporine pharmacokinetics in lung transplant recipients without cystic fibrosis
Author(s) -
Méndez Alejandra,
Monforte Víctor,
Berastegui Cristina,
LópezMeseguer Manuel,
Bravo Carlos,
Pou Leonor,
Roman Antonio
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12371
Subject(s) - medicine , pharmacokinetics , cystic fibrosis , lung , lung transplantation , gastroenterology , coefficient of variation , area under the curve , correlation , statistics , geometry , mathematics
Background There has been little study on the variability of CsA pharmacokinetics in stable lung transplant ( LT ) recipients without cystic fibrosis. This study was conducted to determine the prevalence of high intra‐individual variability of CsA in LT recipients and its implications in CsA monitoring. Methods Twenty‐nine pharmacokinetic curves were performed in 10 consecutive stable patients from a single center. The intra‐individual coefficient of variation ( CV ) of the AUC 0–12 h was calculated in each case. Patients were grouped according to whether their CV was high (≥20%) or low (<20%). Correlations between cyclosporine CsA concentration at each time point, AUC 0–4 h , and AUC 0–12 h were also calculated. Results Six (60%) patients presented low CV s and four (40%) high CV s. In patients with low CV s, the best correlation of AUC 0–12 h was with CsA concentration at two h post‐dose ( C 2 ) ( r = 0.674, p = 0.002), whereas in those with high CV , the best correlation was with C 5 ( r = 0.800, p = 0.003). In the latter group, the correlation with C 2 was low ( r = 0.327, p = 0.32), whereas the correlation with C 0 was high ( r = 0.709, p < 0.05). Conclusions Intra‐individual variability of CsA pharmacokinetics may be high in many LT recipients. In patients with high CV , the use of C 0 levels may be more appropriate for CsA monitoring than C 2 levels.