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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Prospective evaluation of the bayesian method for individualizing tacrolimus dose early after living-donor liver transplantation.
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Prospective evaluation of the bayesian method for individualizing tacrolimus dose early after living-donor liver transplantation.

机译：贝叶斯方法在活体供肝移植后早期个体化他克莫司剂量的前瞻性评估。

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摘要

Tacrolimus is widely used to prevent acute rejection after transplantation, but achieving therapeutic blood concentrations of tacrolimus is often difficult because of large pharmacokinetic variability. In this study, the applicability of the Bayesian method to individualize tacrolimus dose was prospectively examined. Twenty adult recipients (Bayesian group) and another 20 adult patients (control group), all of whom underwent living-donor liver transplantation, were enrolled in this study. In the Bayesian group, the dose of tacrolimus during the first 3 and 4 weeks after surgery was adjusted with the Bayesian method using a population pharmacokinetic model, targeting a trough level of 5 to 12 ng/mL. The interindividual variability in tacrolimus concentrations was significantly reduced in the Bayesian group compared with the control group (average percentage coefficient of variation for all occasions, 32% vs 44% and 31% vs 39% in the first 3 and 4 weeks, respectively). In addition, more patients achieved the target concentrations in the Bayesian group than in the control group (average for all occasions, 85% vs 59% and 83% vs 70% in the first 3 and 4 weeks, respectively). These findings suggest that the Bayesian method can be used to calculate maintenance doses of tacrolimus in adult patients early after living-donor liver transplantation.
机译：他克莫司被广泛用于预防移植后的急性排斥反应，但由于药物动力学的差异较大，通常难以达到他克莫司的治疗血药浓度。在这项研究中，前瞻性地检查了贝叶斯方法对他克莫司剂量个体化的适用性。这项研究招募了二十名成人接受者（贝叶斯组）和另外20名成年患者（对照组），他们均接受了活体供体肝移植。在贝叶斯组中，使用群体药代动力学模型通过贝叶斯方法调整手术后前3周和4周期间他克莫司的剂量，其谷水平为5至12 ng / mL。与对照组相比，贝叶斯组他克莫司浓度的个体间差异显着降低（所有情况下的平均变异系数百分比，前3周和4周分别为32％vs 44％和31％vs 39％）。此外，在贝叶斯组中达到目标浓度的患者比对照组要多（在所有情况下，前3周和4周的平均值分别为85％vs 59％和83％vs 70％）。这些发现表明，贝叶斯方法可用于计算活体供肝移植后成年患者他克莫司的维持剂量。

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