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A limited sampling strategy for the simultaneous estimation of tacrolimus, mycophenolic acid and unbound prednisolone exposure in adult kidney transplant recipients
Author(s) -
BARRACLOUGH KATHERINE A,
ISBEL NICOLE M,
JOHNSON DAVID W,
HAWLEY CARMEL M,
LEE KATIE J,
MCWHINNEY BRETT C,
UNGERER JACOBUS P,
CAMPBELL SCOTT B,
LEARY DIANA R,
STAATZ CHRISTINE E
Publication year - 2012
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2011.01560.x
Subject(s) - tacrolimus , medicine , mycophenolic acid , prednisolone , kidney transplant , kidney transplantation , jackknife resampling , urology , pharmacology , transplantation , statistics , mathematics , estimator
Aim: The aim of this study was to develop a limited sampling strategy (LSS) for the simultaneous estimation of exposure to tacrolimus, mycophenolic acid and unbound prednisolone in adult kidney transplant recipients. Methods: Tacrolimus, mycophenolic acid and unbound prednisolone area under the concentration–time curve profiles from 0 to 12 h post dose (AUC 0‐12 ) were collected from 20 subjects. Multiple linear regression analyses were performed to develop a LSS enabling the simultaneous estimation of exposure to all three drugs. Median percentage prediction error and median absolute percentage prediction error were calculated via jackknife analysis to evaluate bias and imprecision. Results: LSS showed superior ability to predict exposure compared with single concentration–time points. A LSS incorporating concentration measurements at 0.5 h (C 0.5 ), 2 h (C 2 ) and 4 h (C 4 ) post dose displayed acceptable predictive ability for all three drugs. Conclusion: This LSS may serve as a useful research tool for further investigation of the utility of concentration monitoring of these medications.