Article
Licensed
Unlicensed
Requires Authentication
Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
-
Natalia Lampón
Published/Copyright:
May 17, 2011
Abstract
Background: Recently, the use of the truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid (MPA) has been proposed for therapeutic monitoring in liver transplant recipients. The aim of our study was the evaluation of the clinical usefulness of truncated AUC0–2 in kidney transplant patients.
Methods: Plasma MPA was measured in samples taken before the morning dose of mycophenolate mofetil, and one-half and 2 h post-dose, completing 63 MPA concentration-time profiles from 40 adult kidney transplant recipients. The AUC from 0 to 12 h (AUC0–12) was calculated using the validated algorithm of Pawinski et al. The truncated AUC0–2 was calculated using the linear trapezoidal rule, and extrapolated to 0–12 h (trapezoidal extrapolated AUC0–12) as previously described.
Results: Algorithm calculated and trapezoidal extrapolated AUC0–12 values showed high correlation (r=0.995) and acceptable dispersion (ma68=0.71 μg·h/mL), median prediction error (6.6%) and median absolute prediction error (12.6%). The truncated AUC0–2 had acceptable diagnostic efficiency (87%) in the classification of subtherapeutic, therapeutic or supratherapeutic values with respect to AUC0–12. However, due to the high inter-individual variation of the drug absorption-rate, the dispersion between both pharmacokinetic variables (ma68=6.9 μg·h/mL) was unacceptable.
Conclusions: The substantial dispersion between truncated AUC0–2 and AUC0–12 values may be a serious objection for the routine use of MPA AUC0–2 in clinical practice.
Keywords: mycophenolic acid; renal transplantation; therapeutic drug monitoring; truncated area under the curve
Received: 2010-12-22
Accepted: 2011-2-18
Published Online: 2011-05-17
Published in Print: 2011-07-01
©2011 by Walter de Gruyter Berlin Boston
You are currently not able to access this content.
You are currently not able to access this content.
Articles in the same Issue
- Editorial
- Method comparison: where do we draw the line?
- Review
- Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods
- Minireview
- Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications
- Opinion Paper
- Preanalytical quality improvement: from dream to reality
- Point
- Towards more complete specifications for acceptable analytical performance – a plea for error grid analysis
- Counterpoint
- Closing the brain-to-brain loop in laboratory testing
- General Clinical Chemistry and Laboratory Medicine
- Harmonization of growth hormone measurements with different immunoassays by data adjustment
- Comparison of the results from two different External Quality Assessment Schemes supports the utility of robust quality specifications
- High-throughput LC-MS/MS method for monitoring sirolimus and everolimus in the routine clinical laboratory
- Performance of the Roche Total Mycophenolic Acid® assay on the Cobas Integra 400®, Cobas 6000® and comparison to LC-MS/MS in liver transplant patients
- Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
- Good performance of an immunoassay based method for nevirapine measurements in human breast milk
- Measurement of plasma amino acids by Ultraperformance® Liquid Chromatography
- Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers
- Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases
- Direct chromogenic substrate immuno-capture activity assay for testing of factor VII-activating protease
- The antinuclear antibody assay: developing criteria for reflexive anti-dsDNA antibody testing in a laboratory setting
- A simple liquid chromatography-tandem mass spectrometry method for measuring metanephrine and normetanephrine in urine
- Monoclonal gammopathy missed by capillary zone electrophoresis
- Adaptation of the Diazyme Direct Enzymatic HbA1c Assay for a microplate reader at room temperature
- Validation and Outcome Studies
- Laboratory assessment of iron status in pregnancy
- Cardiovascular Diseases
- Blood cells characteristics as determinants of acute myocardial infarction
- No evidence for an association between the rs2824292 variant at chromosome 21q21 and ventricular fibrillation during acute myocardial infarction in a German population
- Letters to the Editor
- Letter to the Editor Reply: Statistical methods for assessment of added usefulness of new biomarkers
- Reply to Vavrova et al. Clin Chem Lab Med 2011;49:89–92
Keywords for this article
mycophenolic acid;
renal transplantation;
therapeutic drug monitoring;
truncated area under the curve
Articles in the same Issue
- Editorial
- Method comparison: where do we draw the line?
- Review
- Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods
- Minireview
- Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications
- Opinion Paper
- Preanalytical quality improvement: from dream to reality
- Point
- Towards more complete specifications for acceptable analytical performance – a plea for error grid analysis
- Counterpoint
- Closing the brain-to-brain loop in laboratory testing
- General Clinical Chemistry and Laboratory Medicine
- Harmonization of growth hormone measurements with different immunoassays by data adjustment
- Comparison of the results from two different External Quality Assessment Schemes supports the utility of robust quality specifications
- High-throughput LC-MS/MS method for monitoring sirolimus and everolimus in the routine clinical laboratory
- Performance of the Roche Total Mycophenolic Acid® assay on the Cobas Integra 400®, Cobas 6000® and comparison to LC-MS/MS in liver transplant patients
- Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
- Good performance of an immunoassay based method for nevirapine measurements in human breast milk
- Measurement of plasma amino acids by Ultraperformance® Liquid Chromatography
- Interchangeability of blood gas, electrolyte and metabolite results measured with point-of-care, blood gas and core laboratory analyzers
- Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases
- Direct chromogenic substrate immuno-capture activity assay for testing of factor VII-activating protease
- The antinuclear antibody assay: developing criteria for reflexive anti-dsDNA antibody testing in a laboratory setting
- A simple liquid chromatography-tandem mass spectrometry method for measuring metanephrine and normetanephrine in urine
- Monoclonal gammopathy missed by capillary zone electrophoresis
- Adaptation of the Diazyme Direct Enzymatic HbA1c Assay for a microplate reader at room temperature
- Validation and Outcome Studies
- Laboratory assessment of iron status in pregnancy
- Cardiovascular Diseases
- Blood cells characteristics as determinants of acute myocardial infarction
- No evidence for an association between the rs2824292 variant at chromosome 21q21 and ventricular fibrillation during acute myocardial infarction in a German population
- Letters to the Editor
- Letter to the Editor Reply: Statistical methods for assessment of added usefulness of new biomarkers
- Reply to Vavrova et al. Clin Chem Lab Med 2011;49:89–92
