Population pharmacokinetics of cyclosporine in clinical renal transplant patients.
Population pharmacokinetics of cyclosporine (CsA) in clinical renal transplant patients has been reported in the present study. A total of 2,548 retrospective drug monitoring data points were collected from 120 renal transplant patients receiving CsA. Population modeling was performed using the NONMEM (nonlinear mixed-effect modeling) program, using a one-compartment model with first-order absorption and elimination. The final regression model for CsA clearance (CL/F) with the influence of six significant covariates, comprising postoperative days (POD), total bilirubin level (TBIL, micromolar concentration), current body weight (CBW, kilograms), age (years), concurrent metabolic inhibitors of cyclosporine (INHI), and hematocrit (HCT, percentage), has been established and expressed as CL/F=28.5 -- 1.24 . POD -- 0.252 . (TBIL -- 11)+0.188 . (CBW -- 58) --0.191 . (Age -- 42) -- 2.45 . INHI -- 0.212 . (HCT-- 28) (liters per hour). The values in parentheses represent the median level for each of the corresponding covariates. The population estimates for CL/F (28.5 l/h), V/F (volume of distribution, 133 l), and interpatient variability (CV%=19.7%) for CL/F were achieved, respectively. The population model was further validated by internal and external approaches, and was demonstrated to be effective and stable. Moreover, simulation was conducted to facilitate the individualized treatment based on patient information and the final model.
Wu
Ke-Hua
KH
Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Cui
Yi-Min
YM
Guo
Jin-Feng
JF
Zhou
Ying
Y
Zhai
Suo-Di
SD
Cui
Fu-De
FD
Lu
Wei
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D007408:Intestinal Absorption; D016030:Kidney Transplantation; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008954:Models, Biological
D007166:Immunosuppressive Agents; D016572:Cyclosporine