Optimal sampling time‑point for cyclosporin A concentration monitoring in heart transplant recipients

  • Authors:
    • Yixin Jia
    • Xu Meng
    • Yan Li
    • Chunlei Xu
    • Wen Zeng
    • Yuqing Jiao
    • Wei Han
  • View Affiliations

  • Published online on: September 10, 2018     https://doi.org/10.3892/etm.2018.6711
  • Pages: 4265-4270
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Abstract

The present study was performed to determine an optimal time‑point for monitoring the concentration of the immunosuppressive drug cyclosporin A (CsA) in heart transplant patients and its efficacy in the prevention of transplant rejection. A total of 32 transplant recipients were randomly assigned for three treatment approaches. Recipients in groups A (n=11), B (n=13) and C (n=8) received oral administration of CsA at doses of 3.2, 3.5 and 4.4 mg/kg, respectively. The plasma CsA concentrations were examined at 2 h intervals over 12 h. Furthermore, their correlation with the 4 h pharmacokinetic profiles as the area under the plasma CsA concentration vs. time curve (AUC0‑4 h) were calculated The efficacy of CsA in inhibiting cardiac allograft rejection was assessed at 2 h after oral CsA intake (C2) and adverse events of the drug were examined in the C2‑monitored recipients. The plasma CsA concentration rapidly increased in most recipients with a peak level detected at ~2 h after dosing. Regression analysis revealed that among all time‑points assessed, the CsA had the highest correlation with the AUC0‑4 h at C2. At C2, increasing CsA doses exhibited a positive association with the measure of AUC0‑4 h. The efficacy of increasing CsA target levels at C2 in preventing heart transplant rejection was comparable, as the survival rate was 100% in all of the treatment groups. However, the proportion of recipients with side effects in group A was obviously lower than that in the other two groups. In conclusion, C2 is an ideal time‑point for monitoring plasma CsA levels with a utility for individualising the next scheduled dose for each patient to ensure that target levels are maintained and achieve a high efficacy and safety of CsA therapy in heart transplant recipients (clinical trial no. 12002610).
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November-2018
Volume 16 Issue 5

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Jia Y, Meng X, Li Y, Xu C, Zeng W, Jiao Y and Han W: Optimal sampling time‑point for cyclosporin A concentration monitoring in heart transplant recipients. Exp Ther Med 16: 4265-4270, 2018.
APA
Jia, Y., Meng, X., Li, Y., Xu, C., Zeng, W., Jiao, Y., & Han, W. (2018). Optimal sampling time‑point for cyclosporin A concentration monitoring in heart transplant recipients. Experimental and Therapeutic Medicine, 16, 4265-4270. https://doi.org/10.3892/etm.2018.6711
MLA
Jia, Y., Meng, X., Li, Y., Xu, C., Zeng, W., Jiao, Y., Han, W."Optimal sampling time‑point for cyclosporin A concentration monitoring in heart transplant recipients". Experimental and Therapeutic Medicine 16.5 (2018): 4265-4270.
Chicago
Jia, Y., Meng, X., Li, Y., Xu, C., Zeng, W., Jiao, Y., Han, W."Optimal sampling time‑point for cyclosporin A concentration monitoring in heart transplant recipients". Experimental and Therapeutic Medicine 16, no. 5 (2018): 4265-4270. https://doi.org/10.3892/etm.2018.6711