Sirolimus steady-state trough concentrations are not affected by bolus methylprednisolone therapy in renal allograft recipients.
OBJECTIVE
To determine whether bolus doses of methylprednisolone affect the steady-state trough concentrations of sirolimus.


METHODS
Fourteen renal transplant recipients received concentration-controlled sirolimus therapy in combination with azathioprine and steroids (n=8) or mycophenolate mofetil and steroids (n=6). Bolus doses of methylprednisolone (mean total dose over 1-5 days, 1694 mg; range, 500-3000 mg) were given for the treatment of acute rejection. For each patient, the sirolimus dose (mean, 24.1 mg; range, 3.3-52.5 mg) was the same before and during methylprednisolone therapy.


RESULTS
Mean sirolimus whole blood trough concentrations before and after treatment with methylprednisolone were 28.8 ng ml-1 (range, 13.9-45.3 ng ml-1), and 28.5 ng ml-1 (range, 13.0-47.9 ng ml-1), respectively (P=0.85; 95% confidence interval on the difference -3.3, 4.0 ng ml-1).


CONCLUSIONS
Bolus methylprednisolone treatment does not affect steady-state sirolimus trough concentrations.
Bäckman
L
L
Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Kreis
H
H
Morales
J M
JM
Wilczek
H
H
Taylor
R
R
Burke
J T
JT
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006084:Graft Rejection / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D020123:Sirolimus / Q000097:blood / Q000627:therapeutic use*
D004338:Drug Combinations; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine; D020123:Sirolimus; D008775:Methylprednisolone