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Clinical Pharmacokinetics

Erschienen in:

11.08.2020 | Systematic Review

Population Pharmacokinetic Models of Tacrolimus in Adult Transplant Recipients: A Systematic Review

verfasst von: Ranita Kirubakaran, Sophie L. Stocker, Stefanie Hennig, Richard O. Day, Jane E. Carland

Erschienen in: Clinical Pharmacokinetics | Ausgabe 11/2020

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Abstract

Background and Objectives

Numerous population pharmacokinetic (PK) models of tacrolimus in adult transplant recipients have been published to characterize tacrolimus PK and facilitate dose individualization. This study aimed to (1) investigate clinical determinants influencing tacrolimus PK, and (2) identify areas requiring additional research to facilitate the use of population PK models to guide tacrolimus dosing decisions.

Methods

The MEDLINE and EMBASE databases, as well as the reference lists of all articles, were searched to identify population PK models of tacrolimus developed from adult transplant recipients published from the inception of the databases to 29 February 2020.

Results

Of the 69 studies identified, 55% were developed from kidney transplant recipients and 30% from liver transplant recipients. Most studies (91%) investigated the oral immediate-release formulation of tacrolimus. Few studies (17%) explained the effect of drug–drug interactions on tacrolimus PK. Only 35% of the studies performed an external evaluation to assess the generalizability of the models. Studies related variability in tacrolimus whole blood clearance among transplant recipients to either cytochrome P450 (CYP) 3A5 genotype (41%), days post-transplant (30%), or hematocrit (29%). Variability in the central volume of distribution was mainly explained by body weight (20% of studies).

Conclusion

The effect of clinically significant drug–drug interactions and different formulations and brands of tacrolimus should be considered for any future tacrolimus population PK model development. Further work is required to assess the generalizability of existing models and identify key factors that influence both initial and maintenance doses of tacrolimus, particularly in heart and lung transplant recipients.

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Titel: Population Pharmacokinetic Models of Tacrolimus in Adult Transplant Recipients: A Systematic Review
verfasst von: Ranita Kirubakaran
Sophie L. Stocker
Stefanie Hennig
Richard O. Day
Jane E. Carland
Publikationsdatum: 11.08.2020
Verlag: Springer International Publishing
Erschienen in: Clinical Pharmacokinetics / Ausgabe 11/2020
Print ISSN: 0312-5963
Elektronische ISSN: 1179-1926
DOI: https://doi.org/10.1007/s40262-020-00922-x

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Population Pharmacokinetic Models of Tacrolimus in Adult Transplant Recipients: A Systematic Review

Abstract

Background and Objectives

Methods

Results

Conclusion

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background and Objectives

Methods

Results

Conclusion

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A Comprehensive Whole-Body Physiologically Based Pharmacokinetic Drug–Drug–Gene Interaction Model of Metformin and Cimetidine in Healthy Adults and Renally Impaired Individuals

Population Pharmacokinetic–Pharmacodynamic Relationships of Sarilumab Using Disease Activity Score 28-Joint C-Reactive Protein and Absolute Neutrophil Counts in Patients with Rheumatoid Arthritis

Prediction of Maternal and Fetal Pharmacokinetics of Dolutegravir and Raltegravir Using Physiologically Based Pharmacokinetic Modeling