A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients

Abstract Background The narrow therapeutic window of tacrolimus (Tac) requires intense drug monitoring to achieve adequate efficacy while minimizing dose‐related toxicities. Once‐daily formulations of Tac (LCP‐Tac and PR‐Tac) have been recently designed for higher bioavailability and a more consiste...

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Autores principales:	Uta Herden, Martina Sterneck, Bettina M. Buchholz, Eike G. Achilles, Armin Ott, Lutz Fischer
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	liver transplantation pharmacokinetics prolonged‐release formulations tacrolimus Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/78bb400793f54590859ccfbee5c26e98
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spelling	oai:doaj.org-article:78bb400793f54590859ccfbee5c26e982021-11-12T19:57:15ZA single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients2050-452710.1002/iid3.537https://doaj.org/article/78bb400793f54590859ccfbee5c26e982021-12-01T00:00:00Zhttps://doi.org/10.1002/iid3.537https://doaj.org/toc/2050-4527Abstract Background The narrow therapeutic window of tacrolimus (Tac) requires intense drug monitoring to achieve adequate efficacy while minimizing dose‐related toxicities. Once‐daily formulations of Tac (LCP‐Tac and PR‐Tac) have been recently designed for higher bioavailability and a more consistent exposure over time, as opposed to the twice‐daily, administered immediate‐release formulation of Tac (IR‐Tac). Methods This single‐center, open‐label, randomized cross‐over pharmacokinetic (PK) study compares extended‐release LCP‐Tac with the prolonged‐release formulation of tacrolimus (PR‐Tac) in adult de novo liver transplant recipients. Eligible patients were screened and randomized 1:1 to the two treatment arms up to 30 days after liver transplantation. Patients were administered either LCP‐Tac or PR‐Tac for 14 days followed by another 14‐day time interval of the other once‐daily Tac medication. A 24hr‐PK profile was obtained at the end of each time interval. Results Nine patients (45%) completed the study resulting in a total of 18 Tac PK profiles. Overall, the profile of the mean concentrations indicated a flattened kinetic of LCP‐Tac compared to PR‐Tac, especially in the first 3 h after drug intake. The average cumulative dose per day to achieve equivalent trough levels was approximately 25% lower for LCP‐Tac (8.7 mg) than for PR‐Tac (11.7 mg). LCP‐Tac resulted in a longer tmax and fewer peak‐to‐trough fluctuations compared to PR‐Tac. Conclusion Despite methodological weaknesses that limit the conclusions, we have found a more consistent drug exposure for LCP‐Tac in de novo LT recipients. LCP‐Tac demonstrated a greater bioavailability compared to PR‐Tac.Uta HerdenMartina SterneckBettina M. BuchholzEike G. AchillesArmin OttLutz FischerWileyarticleliver transplantationpharmacokineticsprolonged‐release formulationstacrolimusImmunologic diseases. AllergyRC581-607ENImmunity, Inflammation and Disease, Vol 9, Iss 4, Pp 1771-1780 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver transplantation pharmacokinetics prolonged‐release formulations tacrolimus Immunologic diseases. Allergy RC581-607
spellingShingle	liver transplantation pharmacokinetics prolonged‐release formulations tacrolimus Immunologic diseases. Allergy RC581-607 Uta Herden Martina Sterneck Bettina M. Buchholz Eike G. Achilles Armin Ott Lutz Fischer A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
description	Abstract Background The narrow therapeutic window of tacrolimus (Tac) requires intense drug monitoring to achieve adequate efficacy while minimizing dose‐related toxicities. Once‐daily formulations of Tac (LCP‐Tac and PR‐Tac) have been recently designed for higher bioavailability and a more consistent exposure over time, as opposed to the twice‐daily, administered immediate‐release formulation of Tac (IR‐Tac). Methods This single‐center, open‐label, randomized cross‐over pharmacokinetic (PK) study compares extended‐release LCP‐Tac with the prolonged‐release formulation of tacrolimus (PR‐Tac) in adult de novo liver transplant recipients. Eligible patients were screened and randomized 1:1 to the two treatment arms up to 30 days after liver transplantation. Patients were administered either LCP‐Tac or PR‐Tac for 14 days followed by another 14‐day time interval of the other once‐daily Tac medication. A 24hr‐PK profile was obtained at the end of each time interval. Results Nine patients (45%) completed the study resulting in a total of 18 Tac PK profiles. Overall, the profile of the mean concentrations indicated a flattened kinetic of LCP‐Tac compared to PR‐Tac, especially in the first 3 h after drug intake. The average cumulative dose per day to achieve equivalent trough levels was approximately 25% lower for LCP‐Tac (8.7 mg) than for PR‐Tac (11.7 mg). LCP‐Tac resulted in a longer tmax and fewer peak‐to‐trough fluctuations compared to PR‐Tac. Conclusion Despite methodological weaknesses that limit the conclusions, we have found a more consistent drug exposure for LCP‐Tac in de novo LT recipients. LCP‐Tac demonstrated a greater bioavailability compared to PR‐Tac.
format	article
author	Uta Herden Martina Sterneck Bettina M. Buchholz Eike G. Achilles Armin Ott Lutz Fischer
author_facet	Uta Herden Martina Sterneck Bettina M. Buchholz Eike G. Achilles Armin Ott Lutz Fischer
author_sort	Uta Herden
title	A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
title_short	A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
title_full	A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
title_fullStr	A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
title_full_unstemmed	A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
title_sort	single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/78bb400793f54590859ccfbee5c26e98
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A single‐center, open‐label, randomized cross‐over study to evaluate the pharmacokinetics and bioavailability of once‐daily prolonged‐release formulations of tacrolimus in de novo liver transplant recipients

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