Interleukin-2 receptor antibody-induced alterations of ciclosporin dose requirements in paediatric transplant recipients.
In a retrospective analysis of paediatric renal-transplant recipients receiving basiliximab, we noted significantly increased blood concentrations of cyclosporin, early cyclosporin toxicity, and a lower dose requirement within the first 10 days compared with controls. As the CD25 saturation fades at days 28-50, cyclosporin concentrations decline and 20% higher doses are required to maintain adequate trough concentrations. We suggest that an interleukin-2 receptor-mediated alteration of the cytochrome P450 system causes this systemic drug interaction and propose that the initial ciclosporin dose should be limited to 400 mg/m2 if used in combination with basiliximab.
Strehlau
J
J
Pape
L
L
Offner
G
G
Nashan
B
B
Ehrich
J H
JH
D000911:Antibodies, Monoclonal / Q000276:immunology / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000077552:Basiliximab; D016022:Case-Control Studies; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood; D004347:Drug Interactions; D006207:Half-Life; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000276:immunology / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016030:Kidney Transplantation; D015375:Receptors, Interleukin-2 / Q000187:drug effects* / Q000276:immunology; D011993:Recombinant Fusion Proteins; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab