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Optimal time for therapeutic drug monitoring of cyclosporine microemulsion in patients with psoriasis
Author(s) -
Umezawa Yoshinori,
Ozawa Akira
Publication year - 2007
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2007.03136.x
Subject(s) - medicine , pharmacokinetics , psoriasis , adverse effect , drug , therapeutic drug monitoring , pharmacology , ciclosporin , oral administration , area under the curve , gastroenterology , chemotherapy , dermatology
Background The clinical usefulness of cyclosporine in patients with psoriasis has generally been established; however, modification of the dosage on the basis of therapeutic drug monitoring is needed to prevent potential adverse reactions. The area under the drug concentration–time curve from 0 to 4 h after treatment (AUC 0−4 ), used to assess the pharmacokinetics of cyclosporine microemulsion, correlates with clinical symptoms and adverse reactions. Methods In order to evaluate the blood collection times after oral treatment that are most relevant to pharmacokinetics, we examined the pharmacokinetics of cyclosporine up to 4 h after treatment in 24 patients with psoriasis vulgaris who received an oral dose of 3.0 mg/kg of cyclosporine microemulsion (Neoral®) daily in two divided doses. Results Our results showed that the blood concentration of cyclosporine 2 h after treatment ( C 2 ) correlated with AUC 0−4 ( r = 0.89, P < 0.001). Conclusions C2 should be monitored in patients treated with cyclosporine microemulsion instead of the blood trough level immediately before treatment, which has conventionally been used to monitor cyclosporine concentrations in blood.