孕妇固体器官移植患者中塔克罗利的药理动力学:一项回顾性研究
Jorn Versluis1, Arno R Bourgonje2, Daan J Touw1,3
1Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
Journal of clinical pharmacology
|December 12, 2023
概括
怀孕移植患者的塔克罗利斯水平在第七个月显著下降,其度与剂量比率下降了48%. 这些塔克罗利斯水平通常在分娩后三个月内恢复.
科学领域:
- 药理学和移植医学 药理学和移植医学
背景情况:
- 关于怀孕期间塔克罗利斯的药理动力学数据有限.
- 了解塔克罗利斯的行为对于管理怀孕的移植接受者至关重要.
研究的目的:
- 在固体器官移植接受者的整个怀孕期间描述全血塔克罗利斯的药理动力学.
- 分析怀孕前,怀孕期间和怀孕后塔克罗利斯度与剂量 (C/D) 比率的变化.
主要方法:
- 在脏,肝脏和肺移植接受者 (46例怀孕) 的回顾性队列研究 (2000-2022).
- 每个月分析完整血液中对剂量 (C/D比率) 进行调整的塔克罗利斯的最低度.
- 使用描述性统计和线性混合模型来评估药理动力学变化.
主要成果:
- 与怀孕前水平相比,在怀孕7个月时,塔克罗利斯C/D比率显著下降了48% (P < .001).
- 这些比率在产后3个月内恢复到基线 (P = .002).
- 延长释放配方的C/D比立即释放更低的趋势 (P = .071);移植类型没有显著影响C/D比率 (P = .873).
结论:
- 在怀孕期间,塔克罗利莫斯全血的药理动力学发生了显著的变化,在7个月后观察到最明显的C/D比率下降.
- 观察到的C/D比率下降趋于从怀孕的第四个月开始稳定.
- 塔克罗利马斯水平通常在产后三个月内正常化,这表明怀孕期间和之后的可预测的药理动力学模式.
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