在肺移植中持续静脉注射的塔克罗利斯的临床药理动力学研究
You Min Sohn1,2, Ryoung-Eun Ko3, Hyo Jung Park1
1Department of Pharmaceutical Services, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Journal of thoracic disease
|July 10, 2023
概括
肺移植后早期使用塔克罗利斯可以在一周内达到治疗药物水平. 这种免疫抑制策略,使用每日剂量调整,尽量减少不良事件,尽管药物度变化.
科学领域:
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
- 移植医学 移植医学
背景情况:
- 塔克罗利马斯对于肺移植后的免疫抑制至关重要.
- 对于早期移植后的塔克罗利斯,最佳的剂量策略和治疗范围的时间尚未确定.
研究的目的:
- 评估肺移植接受者早期,密集管理的塔克罗利斯剂量方案的疗效和安全性.
- 为了确定达到治疗性塔克罗利斯水平的时间和相关的药理动力学变异性.
主要方法:
- 一个单一中心的队列研究,涉及67名成年肺移植接受者.
- 移植后立即开始服用0.01 mg/kg/天的静脉注射.
- 每日最低度监测和剂量定位由临床药剂师进行,目标为10-15 ng/mL.
主要成果:
- 治疗范围 (TTR_to) 的中位时间为7天.
- 治疗范围中的中位时间 (TTR_in) 在前两周为35.7%.
- 急性损伤发生在34.3%的患者中;30天内没有神经毒性或急性细胞排斥.
结论:
- 静脉注射塔克罗利斯与每日剂量定位使得肺移植后迅速达到治疗水平.
- 这种方法在早期的术后期似乎是安全的,可控的不良事件.
- 尽管达到目标度,但高的药理动力学变异性需要持续监测.
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