조혈모세포이식에서 정맥투여 Cyclosporine의 경구 전환시 용량제시
Dosage determination in changing from intravenous cyclosporine to oral formulation in hematopoietic cell transplantation
1
조회
0
다운로드
1
인용
0
참고문헌
초록
Abstract
Few studies have been done on the pharmacokinetics of Cyclosporin A(CsA) in Korean hematopoietic cell transplantation(HCT) patients. The aim of this study is to determine CsA oral dose when changed from intravenous(i.v.) formulation in HCT patients. This study was performed in retrospective and non-randomized study design. HCT and oral CsA dose adjustment underwent patients who received CsA were enrolled and patients whose CsA dose adjustments were done over 14 days from HCT date were excluded. Patients’demographic data and medication information of CsA administration were collected from electronic medical record(EMR). Total 102 patients were studied. The first ratio that changed from i.v. form to oral formulation was 2.08 ± 0.48(mean±SD). After achieving steady state with capsule form, dose adjustment was done secondly and the ratio from iv form to second oral form was 1.59 ± 0.45(mean±SD). This ratio(PO ratio_2) was considered optimal dose changing ratio from i.v. to p.o. formulation in HCT patients. A disproportionate relationship between the lengths of i.v. CsA administration and PO ratio_2 could be found(r2=0.061, p=0.012). Final i.v. dose(mg/kg) and PO ratio_2 was also inversely proportional(r2=0.083, p=0.003). It is rational to use dose ratio of around 1:1.5 or 1:1.6 when an HCT patient convert their i.v. CsA to p.o CsA, considering length of i.v. CsA use and final i.v. dose/kg of patient
참고문헌 (7)
- N. Parquet, "New oral formulation of cyclosporine A(Neoral) pharmacokinetics in allogeneic bone marrow transplant recipient", Bone Marrow Transplantation, 25, pp.965~968 (2000)
- P. Keown, "Cyclosporine microemulsion(Neoral) absorption profiling and sparse-sample predictors during the first 3 months after renal transplantation", American Journal of Transplantation, 2, pp.148~156 (2002)
- Gianpietro Dotti, "Pharmacokinetic study of the new cyclosporine-A formulation( Neoral) in adult allogeneic bone marrow transplant recipients", Haematologica, 86, pp.311~315 (2001)
- T. Ishizawa, "Optimal initial dose of orally administred cyclosporine following intravenous cyclosporine therapy", Transplantation Proceedings, 37, pp.4370~4372 (2005)
- Yi-Min Ku, "Effect of grapefruit juice on the pharmacokinetics of microemulsion cyclosporine and its metabolite in healthy volunteers: Does the formulation difference matter?", Journal of Clinical Pharmacology, 38, pp.959~965 (1998)
- Juan berenguer, "Itraconazole for experimental pulmonary aspergillosis: Comparison with amphotericin B, interaction with cyclosporine A, and correlation between therapeutic response and itraconazole concentrations in plasma", Antimicrobial agents and Chemotherapy, 38, pp.1303~1308 (1994)
- Yee GC., "Serum cyclosporine concentration and risk of acute graft-versus-host disease after allogeneic marrow transplantation", N Eng J Med, 319, pp.65~70 (1988)