Neoral pharmacokinetics in Latino and Caucasian pediatric renal transplant recipients.
Interpopulation variability of drug pharmacokinetics (PK) has been described. For example, the systemic clearance of nifedipine is higher in Mexicans than Caucasians. African-Americans have a lower cyclosporine bioavailability than Caucasians. Limited data are available in the Latino population. Under identical conditions, we compared the PK profile of Neoral (cyclosporine for microemulsion) obtained in stable pediatric renal transplant recipients of Latino and Caucasian origin. A slightly lower area under the curve (AUC) when corrected for dose per body surface area or per kilogram of body weight was observed in Caucasians compared with Latinos. This difference was more pronounced in the younger age group (< 12 years) with a higher peak-to-trough ratio. However, the Caucasians required a higher dosage of Neoral than the Latinos to achieve that same AUC. There was no difference between the groups in the time (tmax) to reach maximal concentration (Cmax) of Neoral. A higher apparent clearance of the drug was observed in the Caucasians compared with the Latinos, especially in the younger age group. No differences in pre- and post-dose levels were observed between the two groups. These differences might affect dose adjustment between the two subpopulations.
Lemire
J
J
Department of Pediatrics, Division of Pediatric Nephrology, University of California, San Diego, 9500 Gilman Drive, 0831, La Jolla, CA 92093-0831, USA. jalemire@ucsd.edu
Capparelli
E V
EV
Benador
N
N
Grimm
P
P
Macdonald
D
D
Reznik
V
V
D000293:Adolescent; D002648:Child; D016572:Cyclosporine / Q000493:pharmacokinetics* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D044465:White People
D007166:Immunosuppressive Agents; D016572:Cyclosporine