Drug‐level change and optimal dose adjustment of tacrolimus with the use of rifabutin for treating mycobacterial disease in solid organ transplant recipients
Background Little is known about the change in drug level and the need for dose adjustment of calcineurin inhibitor when it is used with rifabutin in solid organ transplant (SOT) recipients. We aimed to analyze whether the drug level of tacrolimus significantly reduced after the use of rifabutin and...
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| Veröffentlicht in: | Transplant infectious disease 2022-08, Vol.24 (4), p.e13893-n/a |
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| creator | Kim, Ock‐Hwa Shim, Tae Sun Jo, Kyung‐Wook |
| description | Background
Little is known about the change in drug level and the need for dose adjustment of calcineurin inhibitor when it is used with rifabutin in solid organ transplant (SOT) recipients. We aimed to analyze whether the drug level of tacrolimus significantly reduced after the use of rifabutin and to assess optimal adjustment of tacrolimus dose in SOT recipients.
Methods
Of the SOT recipients in a tertiary referral center in South Korea in 2000–2019, 50 patients who maintained an unchanged dose of tacrolimus after the use of rifabutin for treating mycobacterial disease were enrolled. Their medical records were reviewed retrospectively.
Results
The mean age of the patients was 53.9 ± 11.5 years. The most commonly transplanted organ was the liver (66.0%). The most common indication of rifabutin use was for treating active tuberculosis (78.0%). After rifabutin initiation, the trough level of tacrolimus decreased significantly to the subtherapeutic range in 38 (76.0%) patients. The drug levels of these 38 patients dropped from 7.2 to 3.8 ng/ml (p |
| doi_str_mv | 10.1111/tid.13893 |
| format | Article |
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Little is known about the change in drug level and the need for dose adjustment of calcineurin inhibitor when it is used with rifabutin in solid organ transplant (SOT) recipients. We aimed to analyze whether the drug level of tacrolimus significantly reduced after the use of rifabutin and to assess optimal adjustment of tacrolimus dose in SOT recipients.
Methods
Of the SOT recipients in a tertiary referral center in South Korea in 2000–2019, 50 patients who maintained an unchanged dose of tacrolimus after the use of rifabutin for treating mycobacterial disease were enrolled. Their medical records were reviewed retrospectively.
Results
The mean age of the patients was 53.9 ± 11.5 years. The most commonly transplanted organ was the liver (66.0%). The most common indication of rifabutin use was for treating active tuberculosis (78.0%). After rifabutin initiation, the trough level of tacrolimus decreased significantly to the subtherapeutic range in 38 (76.0%) patients. The drug levels of these 38 patients dropped from 7.2 to 3.8 ng/ml (p < .001) after rifabutin treatment. In these patients, the median 1.5‐fold increase in the tacrolimus dose was required to restore the drug level to the within‐therapeutic range.
Conclusions
These findings indicate that careful tacrolimus drug‐level monitoring and dose adjustment are necessary for most SOT recipients when rifabutin is administered for the treatment of mycobacterial disease.
Drug‐level change and optimal Dose adjustment.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.13893</identifier><language>eng</language><publisher>Malden: Wiley Subscription Services, Inc</publisher><subject>Calcineurin ; Calcineurin inhibitors ; Drug dosages ; Health services ; Medical records ; mycobacterial disease ; Patients ; Rifabutin ; solid organ transplant ; Tacrolimus ; Tuberculosis</subject><ispartof>Transplant infectious disease, 2022-08, Vol.24 (4), p.e13893-n/a</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2603-9627f9decf579e2cabe3ac3df4ddc71c77a3e6fb68cc9776df75a2b338e5733e3</citedby><cites>FETCH-LOGICAL-c2603-9627f9decf579e2cabe3ac3df4ddc71c77a3e6fb68cc9776df75a2b338e5733e3</cites><orcidid>0000-0002-0619-3590 ; 0000-0002-5949-248X ; 0000-0001-6653-816X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.13893$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.13893$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids></links><search><creatorcontrib>Kim, Ock‐Hwa</creatorcontrib><creatorcontrib>Shim, Tae Sun</creatorcontrib><creatorcontrib>Jo, Kyung‐Wook</creatorcontrib><title>Drug‐level change and optimal dose adjustment of tacrolimus with the use of rifabutin for treating mycobacterial disease in solid organ transplant recipients</title><title>Transplant infectious disease</title><description>Background
Little is known about the change in drug level and the need for dose adjustment of calcineurin inhibitor when it is used with rifabutin in solid organ transplant (SOT) recipients. We aimed to analyze whether the drug level of tacrolimus significantly reduced after the use of rifabutin and to assess optimal adjustment of tacrolimus dose in SOT recipients.
Methods
Of the SOT recipients in a tertiary referral center in South Korea in 2000–2019, 50 patients who maintained an unchanged dose of tacrolimus after the use of rifabutin for treating mycobacterial disease were enrolled. Their medical records were reviewed retrospectively.
Results
The mean age of the patients was 53.9 ± 11.5 years. The most commonly transplanted organ was the liver (66.0%). The most common indication of rifabutin use was for treating active tuberculosis (78.0%). After rifabutin initiation, the trough level of tacrolimus decreased significantly to the subtherapeutic range in 38 (76.0%) patients. The drug levels of these 38 patients dropped from 7.2 to 3.8 ng/ml (p < .001) after rifabutin treatment. In these patients, the median 1.5‐fold increase in the tacrolimus dose was required to restore the drug level to the within‐therapeutic range.
Conclusions
These findings indicate that careful tacrolimus drug‐level monitoring and dose adjustment are necessary for most SOT recipients when rifabutin is administered for the treatment of mycobacterial disease.
Drug‐level change and optimal Dose adjustment.</description><subject>Calcineurin</subject><subject>Calcineurin inhibitors</subject><subject>Drug dosages</subject><subject>Health services</subject><subject>Medical records</subject><subject>mycobacterial disease</subject><subject>Patients</subject><subject>Rifabutin</subject><subject>solid organ transplant</subject><subject>Tacrolimus</subject><subject>Tuberculosis</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kcFO3DAQhqOqSKXAgTew1Et7CDh2EsfHClpAQuICZ8uxx7teJXFqO0V76yPwBrxbn6Szu5yQ6otH48__P5q_KM4relHhuczeXlS8k_xDcVxxKUtOW_ZxX3clY4J_Kj6ntKG0ErKWx8XrdVxWf_-8DPAbBmLWeloB0ZMlYc5-1AOxIWHDbpaUR5gyCY5kbWIY_Lgk8uzzmuQ1kAUpfIre6X7JfiIuRJIjaKxXZNya0GuTIfqdpE-gkUcqoQ56xZWekNZTmgeNJhGMnz3apdPiyOkhwdnbfVI8_fzxeHVb3j_c3F19vy8NaykvZcuEkxaMa4QEZnQPXBtuXW2tEZURQnNoXd92xkghWutEo1nPeQeN4Bz4SfH1oDvH8GuBlNXok4EBx4GwJMXaTtKGN02N6Jd36CYsccLpFBOU8lrUgiL17UDhrlKK4NQccaFxqyqqdlEpjErto0L28sA--wG2_wfV49314cc_eTea3w</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Kim, Ock‐Hwa</creator><creator>Shim, Tae Sun</creator><creator>Jo, Kyung‐Wook</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0619-3590</orcidid><orcidid>https://orcid.org/0000-0002-5949-248X</orcidid><orcidid>https://orcid.org/0000-0001-6653-816X</orcidid></search><sort><creationdate>202208</creationdate><title>Drug‐level change and optimal dose adjustment of tacrolimus with the use of rifabutin for treating mycobacterial disease in solid organ transplant recipients</title><author>Kim, Ock‐Hwa ; Shim, Tae Sun ; Jo, Kyung‐Wook</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2603-9627f9decf579e2cabe3ac3df4ddc71c77a3e6fb68cc9776df75a2b338e5733e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Calcineurin</topic><topic>Calcineurin inhibitors</topic><topic>Drug dosages</topic><topic>Health services</topic><topic>Medical records</topic><topic>mycobacterial disease</topic><topic>Patients</topic><topic>Rifabutin</topic><topic>solid organ transplant</topic><topic>Tacrolimus</topic><topic>Tuberculosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Ock‐Hwa</creatorcontrib><creatorcontrib>Shim, Tae Sun</creatorcontrib><creatorcontrib>Jo, Kyung‐Wook</creatorcontrib><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Ock‐Hwa</au><au>Shim, Tae Sun</au><au>Jo, Kyung‐Wook</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Drug‐level change and optimal dose adjustment of tacrolimus with the use of rifabutin for treating mycobacterial disease in solid organ transplant recipients</atitle><jtitle>Transplant infectious disease</jtitle><date>2022-08</date><risdate>2022</risdate><volume>24</volume><issue>4</issue><spage>e13893</spage><epage>n/a</epage><pages>e13893-n/a</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
Little is known about the change in drug level and the need for dose adjustment of calcineurin inhibitor when it is used with rifabutin in solid organ transplant (SOT) recipients. We aimed to analyze whether the drug level of tacrolimus significantly reduced after the use of rifabutin and to assess optimal adjustment of tacrolimus dose in SOT recipients.
Methods
Of the SOT recipients in a tertiary referral center in South Korea in 2000–2019, 50 patients who maintained an unchanged dose of tacrolimus after the use of rifabutin for treating mycobacterial disease were enrolled. Their medical records were reviewed retrospectively.
Results
The mean age of the patients was 53.9 ± 11.5 years. The most commonly transplanted organ was the liver (66.0%). The most common indication of rifabutin use was for treating active tuberculosis (78.0%). After rifabutin initiation, the trough level of tacrolimus decreased significantly to the subtherapeutic range in 38 (76.0%) patients. The drug levels of these 38 patients dropped from 7.2 to 3.8 ng/ml (p < .001) after rifabutin treatment. In these patients, the median 1.5‐fold increase in the tacrolimus dose was required to restore the drug level to the within‐therapeutic range.
Conclusions
These findings indicate that careful tacrolimus drug‐level monitoring and dose adjustment are necessary for most SOT recipients when rifabutin is administered for the treatment of mycobacterial disease.
Drug‐level change and optimal Dose adjustment.</abstract><cop>Malden</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/tid.13893</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0619-3590</orcidid><orcidid>https://orcid.org/0000-0002-5949-248X</orcidid><orcidid>https://orcid.org/0000-0001-6653-816X</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Calcineurin Calcineurin inhibitors Drug dosages Health services Medical records mycobacterial disease Patients Rifabutin solid organ transplant Tacrolimus Tuberculosis |
| title | Drug‐level change and optimal dose adjustment of tacrolimus with the use of rifabutin for treating mycobacterial disease in solid organ transplant recipients |
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