シクロスポリン経口投与後の小数採血による血中濃度曲線下面積 (AUC) の予測

概要

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Recent study of cyclosporine (CYA) therapeutic monitoring has reported an evaluation of area-under-the-curve (AUC) instead of trough level monitoring. In this paper, the prediction of AUC by a small number of blood samples from renal transplant recipients was investigated.CYA (dose: 1.6-15.0mg/kg/day) was administered orally to the patients (18-52 years old) after renal transplantation every 12hr (8:00AM, 8:00PM). Blood specimens were collected at trough level, 1, 2, 3, 6, 8 and 12hr to determine the whole blood concentration of CYA. The prediction of AUC was calculated according to the multiple linear-regression analysis.The coefficient of determination (r2) between CYA trough levels and AUC measured from a complete set of seven concentrations was 0.7108. In contrast, the predicted AUC calculated from three points (1hr, 3hr and 6hr) was well correlated with the measured AUC (r2=0.9880). The prediction error (%) between measured AUC and predicted AUC calculated from three time points (1hr, 3hr and 6hr) ranged within ±15%.These results suggest that the prediction method by the three time points was very useful for monitoring of CYA therapy on the clinical practice.