薬物動態学の観点から見る免疫抑制薬
2019 年 26 巻 2 号 p. 131-137
詳細
2019 年 26 巻 2 号 p. 131-137
A physiologically based pharmacokinetic model adapted to the clinical data was constructed in order to evaluate the contribution of liver regeneration as well as hepatic and intestine CYP3A5 genotypes on tacrolimus pharmacokinetics in adult patients after living-donor liver transplantation. As a result, the oral clearance of tacrolimus was affected by the CYP3A5 genotypes in both the liver and intestine to the same extent. Population pharmacokinetic and pharmacodynamic analysis of mycophenolate was performed in 49 patients undergoing hematopoietic stem cell transplantation. Simulations based on the final parameters show that the dosage adjustment based on plasma concentrations of mycophenolate is required especially for patients with renal dysfunction and/or diarrhea. In conclusion, pharmacometrics is a useful methodology for individualized and optimized therapy of immunosuppressants.
