Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir
10.3969/j.issn.1674-7445.2023.04.011
- VernacularTitle:奈玛特韦/利托那韦治疗下肾移植受者他克莫司谷浓度个体内变异度及其对血清肌酐的影响
- Author:
Yan ZHANG
1
;
Linkun HU
;
Liyan MIAO
Author Information
1. Department of Pharmacy, the First Affiliated Hospital of Sochow University, Suzhou 215006, China
- Publication Type:Research Article
- Keywords:
Nematvir/ritonavir;
SARS-CoV-2 infection;
Kidney transplantation;
Tacrolimus;
Intra-patient variability;
Serum creatinine;
Estimated glomerular filtration rate;
Drug interaction
- From:
Organ Transplantation
2023;14(4):547-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the intra-patient variability (IPV) of tacrolimus trough concentrations and its effect on serum creatinine (Scr) level in kidney transplant recipients treated with nematvir/ritonavir. Methods Clinical data of 41 kidney transplant recipients infected by SARS-CoV-2 and treated with nematvir/ritonavir were collected. The usage of nematvir/ritonavir and tacrolimus was summarized. The distribution of tacrolimus trough concentrations and the attainment rate of target concentration were analyzed. The correlation between the IPV distribution of tacrolimus trough concentrations and the changes of Scr level was determined. Results Among 41 kidney transplant recipients, 46%(19/41) were given with full- and low-dose nematvir/ritonavir, and 7%(3/41) were given with high-dose nematvir/ritonavir. Use of tacrolimus was discontinued at 24 h before nematvir/ritonavir treatment in 95%(39/41) patients, and at 24 h after use of nematvir/ritonavir in 5%(2/41) patients. Tacrolimus was given at least 3 d after the 5-d course of nematvir/ritonavir in all patients. The attainment rate of tacrolimus trough concentration was 73%(30/41), 30%(3/10), 48%(15/31), 35%(11/31) and 53%(16/30) before, during, 1 week, 2 weeks and 1 month after use of nematvir/ritonavir, respectively. The median IPV was 35%(23%, 51%). Spearman correlation analysis showed that the increase of Scr level was positively correlated with IPV (rs=0.400 7, P=0.028 2). Conclusions The attainment rate of tacrolimus trough concentration is declined in kidney transplant recipients treated with nematvir/ritonavir. The IPV of tacrolimus trough concentrations is elevated. The recipients with higher IPV are prone to an elevation in Scr level.
