A limited sampling strategy for the simultaneous estimation of tacrolimus, mycophenolic acid and unbound prednisolone exposure in adult kidney transplant recipients.
OBJECTIVE
The aim of this study was to develop a limited sampling strategy (LSS) for the simultaneous estimation of exposure to tacrolimus, mycophenolic acid and unbound prednisolone in adult kidney transplant recipients.


METHODS
Tacrolimus, mycophenolic acid and unbound prednisolone area under the concentration-time curve profiles from 0 to 12 h post dose (AUC(0-12)) were collected from 20 subjects. Multiple linear regression analyses were performed to develop a LSS enabling the simultaneous estimation of exposure to all three drugs. Median percentage prediction error and median absolute percentage prediction error were calculated via jackknife analysis to evaluate bias and imprecision.


RESULTS
LSS showed superior ability to predict exposure compared with single concentration-time points. A LSS incorporating concentration measurements at 0.5 h (C(0.5)), 2 h (C(2)) and 4 h (C(4)) post dose displayed acceptable predictive ability for all three drugs.


CONCLUSIONS
This LSS may serve as a useful research tool for further investigation of the utility of concentration monitoring of these medications.
Department of Nephrology, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia. katherine_barraclough@health.qld.gov.au
Katherine A
KA
Barraclough
Nicole M
NM
Isbel
David W
DW
Johnson
Carmel M
CM
Hawley
Katie J
KJ
Lee
Brett C
BC
McWhinney
Jacobus P
JP
Ungerer
Scott B
SB
Campbell
Diana R
DR
Leary
Christine E
CE
Staatz
D000328:Adult; D019540:Area Under Curve; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood*; D016030:Kidney Transplantation; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000097:blood*; D011239:Prednisolone / Q000097:blood*; D016559:Tacrolimus / Q000097:blood*
D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid; D016559:Tacrolimus