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Clinical Chemistry 37: 1905-1908, 1991;
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Clinical Chemistry, Vol 37, 1905-1908, Copyright © 1991 by American Association for Clinical Chemistry

Abbreviated kinetic profiles in area-under-the-curve monitoring of cyclosporine therapy

J Grevel and BD Kahan
Department of Surgery, University of Texas Medical School, Houston 77030.

Abbreviated kinetic profiles can reduce the number of phlebotomies and drug assays, and thereby the cost of area-under-the-curve (AUC) monitoring. In the present investigation, we used two independent data sets: group 1, 101 AUC profiles from 77 stable renal-transplant patients, which included a 5-h sample in addition to the usual 0-, 2-, 4-, 6-, 10-, 14-, and 24-h samples; and group 2, 100 profiles from 50 stable renal-transplant patients before and after a change in their daily oral dose of cyclosporine. Group I demonstrated a fair correlation between cyclosporine trough concentrations and the AUC calculated from a complete set of seven concentrations (r2 = 0.820 and 0.758 for the 24- and 0-h samples, respectively). Stepwise multiple linear-regression analysis revealed that the abbreviated set of three time points (2, 6, and 14 h) explained 96% of the variance in AUC values calculated from the full set of seven samples; additional time points increased the accuracy only slightly. For group 2, we examined the difference between the observed and the predicted concentrations by linear extrapolation; the error in the observed AUC value, compared with the predicted value calculated from seven time points (-13.2% to - 1.2%), was similar to the error from just three time points (-11.5% to 4.5%). Abbreviated AUC profiles involving three time points used with a model equation seem to provide a reliable alternative to full seven- point profiles.


The following articles in journals at HighWire Press have cited this article:


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 J. Am. Soc. Nephrol.Home page
K. MAHALATI, P. BELITSKY, K. WEST, B. KIBERD, A. FRASER, I. SKETRIS, A. S. MACDONALD, V. MCALISTER, and J. LAWEN
Approaching the Therapeutic Window for Cyclosporine in Kidney Transplantation: A Prospective Study
J. Am. Soc. Nephrol., April 1, 2001; 12(4): 828 - 833.
[Abstract] [Full Text] [PDF]

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 Clin. Chem.Home page
D. W. Holt, A. Johnston, B. D. Kahan, R. G. Morris, M. Oellerich, and L. M. Shaw
New Approaches to Cyclosporine Monitoring Raise Further Concerns about Analytical Techniques
Clin. Chem., June 1, 2000; 46(6): 872 - 874.
[Full Text] [PDF]

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 Clin. Chem.Home page
B. Kaplan, H.-U. Meier-Kriesche, K. Napoli, and B. D. Kahan
A Limited Sampling Strategy for Estimating Sirolimus Area-Under-the-Concentration Curve
Clin. Chem., March 1, 1997; 43(3): 539 - 540.
[Full Text] [PDF]


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Copyright © 1991 by the American Association for Clinical Chemistry.