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A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients

BACKGROUND: We investigated whether a low fixed Tac starting dose regimen could lead to a better achievement of Tac target concentrations, as well as an effective immunosuppressive treatment, in Chinese kidney transplant recipients (KTRs). MATERIAL/METHODS: We collected whole-blood and serum samples...

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Autores principales: Tang, Jiang-Tao, Yan, Lin, Wang, Lan-Lan, Bai, Yang-Juan, Li, Ya-Mei, Zou, Yuan-Gao, Li, Yi, van Gelder, Teun, Shi, Yun-Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248022/
https://www.ncbi.nlm.nih.gov/pubmed/29735966
http://dx.doi.org/10.12659/AOT.907666
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author Tang, Jiang-Tao
Yan, Lin
Wang, Lan-Lan
Bai, Yang-Juan
Li, Ya-Mei
Zou, Yuan-Gao
Li, Yi
van Gelder, Teun
Shi, Yun-Ying
author_facet Tang, Jiang-Tao
Yan, Lin
Wang, Lan-Lan
Bai, Yang-Juan
Li, Ya-Mei
Zou, Yuan-Gao
Li, Yi
van Gelder, Teun
Shi, Yun-Ying
author_sort Tang, Jiang-Tao
collection PubMed
description BACKGROUND: We investigated whether a low fixed Tac starting dose regimen could lead to a better achievement of Tac target concentrations, as well as an effective immunosuppressive treatment, in Chinese kidney transplant recipients (KTRs). MATERIAL/METHODS: We collected whole-blood and serum samples from 189 KTRs and the Tac starting dose was 2, 2.5, or 3 mg/day. Information on Tac C(0), dose, body weight, body mass index (BMI), Scr, eGFR, and CYP3A5 genotypes were collected from a routine therapeutic drug monitoring database. The correlation between Tac C(0) and body weight (or BMI) was investigated by calculating the goodness of fit. Multivariable logistic regression was performed to estimate the independent associated factors. RESULTS: The patients with 3 mg per day of Tac had higher C(0) at day 7 compared to those with 2 or 2.5 mg. For patients receiving the same Tac starting dose, no significant difference was found in Tac C(0) at day 7 among different body weight or BMI groups. There was no significant difference in Scr or eGFR at 1 year after transplant, nor was there a significant difference in the rates of DGF or AR at post-transplant day 30 among different Tac starting dose groups or among the 3 Tac C(0) range groups. CYP3A5 genotype and Tac initial dose were independently associated with Tac C(0). CONCLUSIONS: CYP3A5 genotype and Tac initial dose were independently associated with Tac C(0) in renal transplant recipients. Our results suggest that a low Tac target C(0) range (5–8 ng/ml) with a low fixed starting dose (3 mg/day) would be safe and effective among Chinese KTRs.
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spelling pubmed-62480222018-11-28 A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients Tang, Jiang-Tao Yan, Lin Wang, Lan-Lan Bai, Yang-Juan Li, Ya-Mei Zou, Yuan-Gao Li, Yi van Gelder, Teun Shi, Yun-Ying Ann Transplant Original Paper BACKGROUND: We investigated whether a low fixed Tac starting dose regimen could lead to a better achievement of Tac target concentrations, as well as an effective immunosuppressive treatment, in Chinese kidney transplant recipients (KTRs). MATERIAL/METHODS: We collected whole-blood and serum samples from 189 KTRs and the Tac starting dose was 2, 2.5, or 3 mg/day. Information on Tac C(0), dose, body weight, body mass index (BMI), Scr, eGFR, and CYP3A5 genotypes were collected from a routine therapeutic drug monitoring database. The correlation between Tac C(0) and body weight (or BMI) was investigated by calculating the goodness of fit. Multivariable logistic regression was performed to estimate the independent associated factors. RESULTS: The patients with 3 mg per day of Tac had higher C(0) at day 7 compared to those with 2 or 2.5 mg. For patients receiving the same Tac starting dose, no significant difference was found in Tac C(0) at day 7 among different body weight or BMI groups. There was no significant difference in Scr or eGFR at 1 year after transplant, nor was there a significant difference in the rates of DGF or AR at post-transplant day 30 among different Tac starting dose groups or among the 3 Tac C(0) range groups. CYP3A5 genotype and Tac initial dose were independently associated with Tac C(0). CONCLUSIONS: CYP3A5 genotype and Tac initial dose were independently associated with Tac C(0) in renal transplant recipients. Our results suggest that a low Tac target C(0) range (5–8 ng/ml) with a low fixed starting dose (3 mg/day) would be safe and effective among Chinese KTRs. International Scientific Literature, Inc. 2018-05-08 /pmc/articles/PMC6248022/ /pubmed/29735966 http://dx.doi.org/10.12659/AOT.907666 Text en © Ann Transplant, 2018 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Paper
Tang, Jiang-Tao
Yan, Lin
Wang, Lan-Lan
Bai, Yang-Juan
Li, Ya-Mei
Zou, Yuan-Gao
Li, Yi
van Gelder, Teun
Shi, Yun-Ying
A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title_full A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title_fullStr A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title_full_unstemmed A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title_short A Low Fixed Tacrolimus Starting Dose Is Effective and Safe in Chinese Renal Transplantation Recipients
title_sort low fixed tacrolimus starting dose is effective and safe in chinese renal transplantation recipients
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248022/
https://www.ncbi.nlm.nih.gov/pubmed/29735966
http://dx.doi.org/10.12659/AOT.907666
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