Clinical experience of conversion from twice-daily standard-release tacrolimus to once-daily prolonged-release tacrolimus in stable renal transplant recipients

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• 作者：Wing Fai  ; Pang ; Kai Ming  ; Chow  ; ;   ; ^{Chow_Kai_Ming@alumni.cuhk.net} ; Bonnie Ching Ha  ; Kwan ; Vickie Wai Ki  ; Kwong ; Cheuk Chun  ; Szeto ; Chi Bon  ; Leung ; Philip Kam-Tao  ; Li
• 关键词：Chinese ; Immunosuppression ; Pharmacokinetics ; Renal transplant ; Tacrolimus
• 刊名：Hong Kong Journal of Nephrology
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：13
• 期：2
• 页码：64-67
• 全文大小：305 K

文摘

Summary

Background

Conversion of standard-release tacrolimus to prolonged-release once-daily tacrolimus is often performed in a 1:1 (mg:mg) manner. We sought to determine the safety and efficacy of this conversion strategy in Chinese renal transplant recipients.

Methods

In this single-center study, 16 stable renal transplant recipients were observed for 1 year after a milligram to milligram switch from standard-release to prolonged-release tacrolimus formulation. Trough blood tacrolimus level and graft function were serially monitored.

Results

Mean daily dose of tacrolimus was 0.040 ¡À 0.018 mg/kg before conversion. After conversion, we observed a significant decrease in trough tacrolimus levels, from 4.5 ¡À 2.2 ng/mL to 3.4 ¡À 1.1 ng/mL (p = 0.046) at 1 month, and from 4.5 ¡À 2.2 ng/mL to 3.3 ¡À 1.1 ng/mL (p = 0.01) at 12 months. After 12 months, 44 % of patients (n = 7) experienced a decrease in tacrolimus blood levels of more than 20 % . All patients maintained stable graft function otherwise, without acute rejection.

Conclusion

Our findings confirm that trough tacrolimus blood level can decrease following a 1:1 (mg:mg) conversion from standard-release to prolonged-release tacrolimus formulation in Chinese patients. Close monitoring of the drug levels and clinical condition seems to be warranted after medication switch.

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