Evaluation of limited sampling strategies for total and free prednisolone in adult kidney transplant recipients

Purpose The aims of this study were to evaluate the predictive performances of all previously derived limited sampling strategies (LSSs) for total prednisolone, and to derive LSSs for free prednisolone in an independent cohort of adult kidney transplant recipients. Methods Total and free prednisolone area under the concentration–time curve profiles from 0 to 12 hours post-dose (AUC 0–12 ) were collected from 20 subjects. All previously published total prednisolone LSSs were identified from the literature. Free prednisolone LSSs were developed using multiple linear regression analyses. AUC predicted by each of the LSSs was compared with AUC 0–12 . Median percentage prediction error (MPPE) and median absolute percentage prediction error (MAPE) were calculated to evaluate bias and imprecision. Results Total dose-adjusted prednisolone exposure varied 5-fold among study participants, while free dose-adjusted prednisolone exposure varied 3-fold. Correlation (r 2 ) between total and free prednisolone AUC 0–12 was 0.79 ( p =