Advantages of Computerized Dosing Strategy in Tacrolimus Treatment of Renal Transplant Patients.

S.-Y. Kim,¹ S. Cho,¹ M.-J. Cho,¹ C. Lee,¹ A. Han,¹ C. Choi,¹ S. Ahn,¹ S.-I. Min,¹ S.-K. Min,¹ M. Park,² I. Jung,³ S. Kim,⁴ J. Ha.^1,2

¹Department of Surgery, Seoul National University Hospital, Seoul, Korea
²Korea Organ Donation Agency, Seoul, Korea
³Department of surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
⁴Department of Surgery, Myoungji Hospital, Goyang-si, Korea.

Meeting: 2016 American Transplant Congress

Abstract number: B121

Keywords: Dosage, FK506, Immunosuppression, Kidney transplantation

Session Information

Session Name: Poster Session B: Drug Minimization

Session Type: Poster Session

Date: Sunday, June 12, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Purpose: Tacrolimus (Tac) is widely used in immunosuppression for kidney transplant (KT) patients. Despite this, it is still difficult for expert physicians to achieve and maintain the target trough level (TTL) of Tac at the early post-KT period. The purpose of this study is to evaluate usefulness of computerized dosing (CD) strategy in Tac using pharmacokinetic model with regard to achievement and maintenance of TTL.

Methods: From March 2015, the dose of Tac was decided by using CD strategy for KT recipients who took Tac twice a day during 8 days after KT and they were enrolled in this study (Group A). Control group was composed of KT recipients who took Tac as determined by conventional dosing strategy that is the calculated dose of Tac by expert physicians from January 2010 to December 2014. By using propensity score matching at 1-to-2, 100 patients were selected among the control group (Group B). The proportion of patients within TTL compared with CD and conventional dosing group at postoperative day (POD) 8.

Results: The basic characteristics were similar between Group A (n=50) and B (n=100) except causes of end stage renal disease. There was a statistical difference in mean concentration of Tac between Group A and B at POD 7 (11.6 vs 8.2 ng/ml, p < 0.001). Mean time to reach TTL was 4.42 ± 2.0 days for Group A and 5.28 ± 2.36 days for Group B (P= 0.027). From POD 5 to POD 7, the proportion of patients within TTL in Group A was higher than that of Group B; At POD 5, 6, and 7, each ratio of group A and B was followed by: 44% vs 17% (P<0.001), 42.0% vs 17% (P=0.001), and 40% vs 25.0% (P=0.059). The mean intra-individual variability (IIV) of Tac trough level in Group A was statistically lower than that in Group B. (IIV; 3.02±1.34 vs 3.63 ±1.96%, P=0.026)

Conclusion: Computerized dosing strategy of Tac has shown early achievement of TTL and it could be the promising alternative method for physicians and patients.

CITATION INFORMATION: Kim S.-Y, Cho S, Cho M.-J, Lee C, Han A, Choi C, Ahn S, Min S.-I, Min S.-K, Park M, Jung I, Kim S, Ha J. Advantages of Computerized Dosing Strategy in Tacrolimus Treatment of Renal Transplant Patients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Kim S-Y, Cho S, Cho M-J, Lee C, Han A, Choi C, Ahn S, Min S-I, Min S-K, Park M, Jung I, Kim S, Ha J. Advantages of Computerized Dosing Strategy in Tacrolimus Treatment of Renal Transplant Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/advantages-of-computerized-dosing-strategy-in-tacrolimus-treatment-of-renal-transplant-patients/. Accessed November 22, 2024.

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