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霉酚酸在韩国肾移植患者中的药代动力学研究。

Pharmacokinetic study of mycophenolic acid in Korean kidney transplant patients.

作者信息

Cho Eun Kyung, Han Duck Jong, Kim Song Cheol, Burckart Gilbert J, Venkataramanan Raman, Oh Jung Mi

机构信息

Graduate School of Clinical Pharmacy, Sookmyung Women's University, 53-12 Chungpadong 2-ka, Yongsan-gu, Seoul, 140-742 Korea.

出版信息

J Clin Pharmacol. 2004 Jul;44(7):743-50. doi: 10.1177/0091270004266634.

Abstract

The purpose of this study was to characterize the pharmacokinetic parameters of mycophenolic acid (MPA) in Korean kidney transplant recipients. Plasma MPA concentrations of 10 Korean kidney transplant recipients administered a lower dose of mycophenolate mofetil (MMF; 750 mg twice a day) were measured at 2 weeks of MMF therapy by high-performance liquid chromatography (HPLC). The plasma MPA concentration-time curve pattern of patients taking lower doses of MPA was consistent with previously reported profiles of patients taking the fully recommended doses. The plasma MPA concentration-time curve was characterized by an early sharp peak within 1 hour and a small second peak in some patients at 4 to 12 hours postdose. The mean C(max) and AUC were 8.73 +/- 4.65 microg/mL and 18.45 +/- 4.25 microg*h/mL, respectively. The mean fraction of free MPA was 1.60% +/- 0.23%. Patients' age, weight, body surface area, and renal function did not influence the AUC. The free fraction of MPA appeared not to be affected by serum albumin and renal function when creatinine clearance was above 40 mL/min. Regression analysis between each plasma concentration and AUC for the limited sampling strategy of MMF therapeutic drug monitoring demonstrated that the concentrations of predose and 1- and 8-hour postdose were positively correlated with AUC (r = 0.74545, p = 0.0133; r = 0.68485, p = 0.0289; and r = 0.63636, p = 0.0479, respectively). The pattern of the concentration-time profile of MPA in Korean kidney recipients was similar to the results of other studies performed in Caucasians, although there was interindividual variability of AUC, C(max), and t(max). MPA concentrations of predose and 1- and 8-hour postdose were positively correlated with AUC.

摘要

本研究的目的是确定霉酚酸(MPA)在韩国肾移植受者中的药代动力学参数。采用高效液相色谱法(HPLC)测定了10例接受较低剂量霉酚酸酯(MMF;每日两次,每次750 mg)治疗的韩国肾移植受者在MMF治疗2周时的血浆MPA浓度。服用较低剂量MPA患者的血浆MPA浓度-时间曲线模式与先前报道的服用完全推荐剂量患者的曲线一致。血浆MPA浓度-时间曲线的特征是给药后1小时内出现早期尖峰,部分患者在给药后4至12小时出现小的第二个峰。平均C(max)和AUC分别为8.73±4.65μg/mL和18.45±4.25μg*h/mL。游离MPA的平均比例为1.60%±0.23%。患者的年龄、体重、体表面积和肾功能不影响AUC。当肌酐清除率高于40 mL/min时,MPA的游离比例似乎不受血清白蛋白和肾功能的影响。MMF治疗药物监测的有限采样策略下,各血浆浓度与AUC之间的回归分析表明,给药前、给药后1小时和8小时的浓度与AUC呈正相关(r分别为0.74545,p = 0.0133;r = 0.68485,p = 0.0289;r = 0.63636,p = 0.0479)。韩国肾移植受者中MPA浓度-时间曲线的模式与在白种人中进行的其他研究结果相似,尽管AUC、C(max)和t(max)存在个体间差异。给药前、给药后1小时和8小时的MPA浓度与AUC呈正相关。

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