The clinical benefits of cyclosporine C2-level monitoring: a systematic review.

摘要: Background Monitoring of cyclosporine microemulsion (Neoral) using 2-hour postdose (C2) levels is alleged to improve clinical outcomes, but the efficacy this strategy uncertain. Methods A systematic literature search was performed for trials directly comparing patients monitored with C2 those by trough (C0) levels. Primary outcomes assessed were renal function and acute rejection. Results total 29 studies met inclusion criteria. Only 10 these randomized controlled trials. Overall quality poor precluded meta-analysis. The most consistent finding in de novo renal, hepatic, cardiac transplant recipients a higher mean dose early postoperative period patients. There no clear evidence that leads impaired function. In majority studies, monitoring had significant effect on rate stable recipients, show reduction adoption monitoring. No obvious benefit derived from dose. Conclusion patients, there little prospective support theoretical benefits Potential reductions may reduce costs, short-term seen. Quality area poor, practical limitations further required before administration based can be recommended.