Lemaitre Florian, Monchaud Caroline, Woillard Jean-Baptiste, Picard Nicolas, Marquet Pierre
Inserm, EHESP, institut de recherche en santé, environnement et travail (Irset) - UMRS 1085, université Rennes, CHU Rennes, 35000 Rennes, France; Inserm, centre d'investigation clinique 1414, 35000 Rennes, France.
Service de pharmacologie, toxicologie et pharmacovigilance, CHU Limoges, 87000 Limoges, France; Inserm, UMR-1248, 87000 Limoges, France.
Therapie. 2020 Nov-Dec;75(6):681-685. doi: 10.1016/j.therap.2020.06.004. Epub 2020 Jun 20.
Recently, the International Association of Therapeutic Drug Monitoring (IATDMCT), that is the learning society for biological pharmacology and toxicology, issued recommendations on the therapeutic drug monitoring (TDM) of tacrolimus. This is the second consensus after the one issued in 2009. In this document, the role of tacrolimus TDM for the four principal transplanted organs is discussed. The analytical aspects, pharmacogenetics, TDM alternative approaches and the positioning of biomarkers are also presented. Stronger recommendations are about trough concentration targets in kidney and liver transplantation and for other indication of tacrolimus use. For the first time, an area under the curve of tacrolimus concentrations target is recommended for recipients management. Eventually, another set of recommendations are proposed for pharmacodynamic biomarkers used in patients' follow-up.
最近,国际治疗药物监测协会(IATDMCT),即生物药理学和毒理学的学术团体,发布了关于他克莫司治疗药物监测(TDM)的建议。这是继2009年发布的共识之后的第二个共识。在这份文件中,讨论了他克莫司TDM在四种主要移植器官中的作用。还介绍了分析方面、药物遗传学、TDM替代方法以及生物标志物的定位。对于肾移植和肝移植以及他克莫司使用的其他适应症,关于谷浓度目标有更强有力的建议。首次推荐了他克莫司浓度目标曲线下面积用于受者管理。最后,针对患者随访中使用的药效学生物标志物提出了另一组建议。