title: Evaluation of limited sampling strategies for tacrolimus.
abstract: OBJECTIVE
  In literature, a great diversity of limited sampling strategies (LSS) have been recommended for tacrolimus monitoring, however proper validation of these strategies to accurately predict the area under the time concentration curve (AUC0-12) is limited. The aim of this study was to determine whether these LSS might be useful for AUC prediction of other patient populations.
  
  
  METHODS
  The LSS from literature studied were based on regression equations or on Bayesian fitting using MWPHARM 3.50 (Mediware, Groningen, the Netherlands). The performance was evaluated on 24 of these LSS in our population of 37 renal transplant patients with known AUCs. The results were also compared with the predictability of the regression equation based on the trough concentrations C0 and C12 of these 37 patients. Criterion was an absolute prediction error (APE) that differed less than 15% from the complete AUC0-12 calculated by the trapezoidal rule.
  
  
  RESULTS
  Thirteen of the 18 (72%) LSS based on regression analysis were capable of predicting at least 90% of the 37 individual AUC0-12 within an APE of 15%. Additionally, all but three LSS examined gave a better prediction of the complete AUC0-12 in comparison with the trough concentrations C0 or C12 (mean 62%). All six LSS based on Bayesian fitting predicted <90% of the 37 complete AUC0-12 correctly (mean 67%).
  
  
  CONCLUSIONS
  The present study indicated that implementation of LSS based on regression analysis could produce satisfactory predictions although careful evaluation is necessary.
authors: Department of Clinical Chemistry, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. RBUY@klinchem.azm.nl
authors: Robert A M
authors: RA
authors: Op den Buijsch
authors: Afke
authors: A
authors: van de Plas
authors: Leo M L
authors: LM
authors: Stolk
authors: Maarten H L
authors: MH
authors: Christiaans
authors: Johannes P
authors: JP
authors: van Hooff
authors: Nas A
authors: NA
authors: Undre
authors: Marja P
authors: MP
authors: van Dieijen-Visser
authors: Otto
authors: O
authors: Bekers
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001499:Bayes Theorem; D002986:Clinical Trials as Topic; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005544:Forecasting; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D016559:Tacrolimus / Q000493:pharmacokinetics*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus
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