Two-hour cyclosporine concentration determination: an appropriate tool to monitor neoral therapy?

摘要: Cyclosporine is a critical dose drug for which individualisation by therapeutic monitoring indisputable. Current evidence suggests that single concentration (C 2 ) taken two hours after cyclosporine administration with the microemulsion formulation better predicts exposure and events than trough 0 ), routinely used adjusting dosage of this drug. Studies have shown greatest calcineurin inhibition maximum IL-2 production occur in first I to dosing. These findings support concept C level reflects immunosuppressive efficacy concentration. Preliminary data from an outcome study liver transplant recipients incidence biopsy proven moderate severe acute rejection was significantly lower patients managed compared those monitored . The importance achieving adequate during 3 5 posttransplant days prevent has been documented prospective studies de novo renal recipients. Conversion maintenance heart resulted amelioration function. Time-dependent target values proposed require further validation. For routine levels on-site validated dilution guidelines are necessary most available immunoassays. necessitates organizational requirements may be judged differently between centers. In particular early period promising new option make therapy safer more efficient.