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The Impact of Spironolactone Co-administration on Cyclosporin Initial Dosage Optimization for Pediatric Refractory Nephrotic Syndrome.
Han, Huan-Huan; Rui, Min; Yang, Yang; Cui, Jia-Fang; Huang, Xue-Ting; Zhang, Shi-Jia; He, Su-Mei; Wang, Dong-Dong; Chen, Xiao.
Afiliación
  • Han HH; Department of Pharmacy, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu 222000, China.
  • Rui M; Department of Orthopaedics, The Affiliated Jiangyin Clinical College of Xuzhou Medical University, Jiangyin, Jiangsu 214400, China.
  • Yang Y; Department of Pharmacy, The Affiliated Changzhou Children's Hospital of Nantong University, Changzhou, Jiangsu 213003, China.
  • Cui JF; Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
  • Huang XT; Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
  • Zhang SJ; Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
  • He SM; Department of Pharmacy, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jiangsu 215153, China.
  • Wang DD; Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
  • Chen X; School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
Curr Pharm Des ; 30(18): 1419-1432, 2024.
Article en En | MEDLINE | ID: mdl-38639271
ABSTRACT

OBJECTIVES:

Cyclosporin has been used for the treatment of pediatric refractory nephrotic syndrome (PRNS). However, the narrow therapeutic window and large pharmacokinetic variability make it difficult to individualize cyclosporin administration. Meanwhile, spironolactone has been reported to affect cyclosporin metabolism in PRNS patients. This study aims to explore the initial dosage optimization of cyclosporin in PRNS based on the impact of spironolactone co-administration.

METHODS:

Monte Carlo simulation based on a previously established cyclosporin population pharmacokinetic model for PRNS was used to design cyclosporin dosing regimen.

RESULTS:

In this study, the probability of drug concentration reaching the target and the convenience of times of administration were considered comprehensively. The optimal administration regimen in PRNS without spironolactone was 6, 5, 4 and 3 mg/kg cyclosporin split into two doses for the body weight of 5-8, 8-18, 18-46 and 46-70 kg, respectively. The optimal administration regimen in PRNS with spironolactone was 4, 3, 2 mg/kg cyclosporin split into two doses for body weight of 5-14, 14-65, and 65-70 kg, respectively.

CONCLUSION:

The cyclosporin dosing regimen for PRNS based on Monte Carlo simulation was systematically developed and the initial dosage optimization of cyclosporin in PRNS was recommended for the first time.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espironolactona / Método de Montecarlo / Ciclosporina / Inmunosupresores / Síndrome Nefrótico Límite: Child / Child, preschool / Humans Idioma: En Revista: Curr Pharm Des Asunto de la revista: FARMACIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Emiratos Árabes Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espironolactona / Método de Montecarlo / Ciclosporina / Inmunosupresores / Síndrome Nefrótico Límite: Child / Child, preschool / Humans Idioma: En Revista: Curr Pharm Des Asunto de la revista: FARMACIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Emiratos Árabes Unidos