A limited sampling strategy for the simultaneous estimation of tacrolimus, mycophenolic acid and unbound prednisolone exposure in adult kidney transplant recipients

Barraclough, Katherine A., Isbel, Nicole M., Johnson, David W., Hawley, Carmel M., Lee, Katie J., Mcwhinney, Brett C., Ungerer, Jacobus P., Campbell, Scott B., Leary, Diana R. and Staatz, Christine E. (2012) A limited sampling strategy for the simultaneous estimation of tacrolimus, mycophenolic acid and unbound prednisolone exposure in adult kidney transplant recipients. Nephrology, 17 3: 294-299.


Author Barraclough, Katherine A.
Isbel, Nicole M.
Johnson, David W.
Hawley, Carmel M.
Lee, Katie J.
Mcwhinney, Brett C.
Ungerer, Jacobus P.
Campbell, Scott B.
Leary, Diana R.
Staatz, Christine E.
Title A limited sampling strategy for the simultaneous estimation of tacrolimus, mycophenolic acid and unbound prednisolone exposure in adult kidney transplant recipients
Journal name Nephrology  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2012-03
Sub-type Article
DOI 10.1111/j.1440-1797.2011.01560.x
Volume number 17
Issue number 3
ISSN 1320-5358;1440-1797
Start page 294
End page 299
Total pages 6
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract Aim:
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.

Conclusion:
This LSS may serve as a useful research tool for further investigation of the utility of concentration monitoring of these medications. In this study, the authors have examined the predictive performance indices for three immunosuppressive drugs (tacrolimus, mycophenolic acid and prednisolone) using limited sampling at 0.5, 2 and 4 h post dose. Measurements for all three drugs demonstrated an acceptable predictive ability, making this strategy a potentially useful tool for future research studies.
Keyword Area under the concentration-time curve
Limited sampling strategy
Mycophenolic acid
Prednisolone
Tacrolimus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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