Hidaka Masaaki, Soyama Akihiko, Hashizume Junya, Hara Takanobu, Matsunaga Noriko, Matsushima Hajime, Tanaka Takayuki, Hamada Takashi, Imamura Hajime, Adachi Tomohiko, Kanetaka Kengo, Ohyama Kaname, Eguchi Susumu
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Hospital Pharmacy, Nagasaki University Hospital, Nagasaki, Japan.
Cancer Diagn Progn. 2022 Sep 3;2(5):553-557. doi: 10.21873/cdp.10141. eCollection 2022 Sep-Oct.
BACKGROUND/AIM: The proton pump inhibitors were reported to affect the blood concentration of tacrolimus. Vonoprazan fumarate is a new acid suppressant with potent acid inhibitory effects. There have been no reports concerning the effect of vonoprazan on the tacrolimus blood concentration in liver transplant (LT) recipients.
Eighteen living donor liver transplantation (LDLT) recipients who switched from proton pump inhibitors (PPIs) to vonoprazan between 2016 to 2018 were enrolled in this retrospective study. We investigated blood levels of tacrolimus, and liver and renal function before and after the change from PPIs to vonoprazan.
The median C /D of tacrolimus before conversion, 3 months after conversion, and 6 months after conversion were 2.33, 1.53, and 1.89, respectively, and there was no significant difference. Conversion from another PPI to vonoprazan was not associated with a worsening liver function. The estimated glomerular filtration rate was significantly worse after conversion.
Vonoprazan can be safely administered to LT recipients receiving tacrolimus during the stable period.
背景/目的：据报道质子泵抑制剂会影响他克莫司的血药浓度。富马酸沃克拉丁是一种新型的具有强效抑酸作用的抑酸剂。目前尚无关于富马酸沃克拉丁对肝移植（LT）受者他克莫司血药浓度影响的报道。
本回顾性研究纳入了2016年至2018年间从质子泵抑制剂（PPI）转换为富马酸沃克拉丁的18例活体肝移植（LDLT）受者。我们调查了从PPI转换为富马酸沃克拉丁前后他克莫司的血药浓度以及肝功能和肾功能。
转换前、转换后3个月和转换后6个月他克莫司的中位C/D分别为2.33、1.53和1.89，差异无统计学意义。从另一种PPI转换为富马酸沃克拉丁与肝功能恶化无关。转换后估计肾小球滤过率显著变差。
在稳定期，富马酸沃克拉丁可安全地用于接受他克莫司治疗的LT受者。
