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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
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Conversion From Twice-Daily to Once-Daily Tacrolimus in Stable Kidney Graft Recipients.
P Barreto1, J Malheiro2, P Vieira3
1Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal; Nephrology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Transplantation Proceedings
|October 16, 2016
Summary
Switching to once-daily tacrolimus (extended-release) is safe and effective for kidney transplant patients. A 1 mg:1.1 mg conversion dose may offer advantages for some individuals, improving adherence.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pharmacology
Background:
- Immunosuppression is critical in kidney transplantation.
- A new prolonged-release tacrolimus formulation offers once-daily dosing for improved patient adherence.
Purpose of the Study:
- To evaluate the efficacy and safety of converting stable kidney transplant recipients from twice-daily tacrolimus to a once-daily prolonged-release formulation.
- To assess the impact of different conversion ratios (1 mg:1 mg vs. 1 mg:1.1 mg) on tacrolimus blood levels and renal function.
Main Methods:
- Retrospective analysis of clinical and analytical data from 60 stable kidney transplant recipients.
- Conversion from twice-daily tacrolimus to once-daily formulation using 1 mg:1 mg or 1 mg:1.1 mg ratios.
- Monitoring of tacrolimus blood levels and glomerular filtration rate (GFR) pre- and post-conversion.
Main Results:
- A significant reduction in tacrolimus blood levels was observed post-conversion, often requiring dose adjustments.
- Higher post-conversion tacrolimus blood level reduction (>25%) was noted in the 1 mg:1 mg conversion group (P=.004).
- Female sex and higher baseline tacrolimus levels were risk factors for significant blood level reduction in the 1 mg:1 mg group. No significant changes in mean GFR were detected.
Conclusions:
- Once-daily tacrolimus is an efficient and safe alternative to twice-daily dosing.
- Conversion using a 1 mg:1.1 mg ratio appears advantageous in certain patient populations.
- The prolonged-release formulation supports convenient dosing and adherence in kidney transplant recipients.
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