In:
Clinical Transplantation, Wiley, Vol. 32, No. 8 ( 2018-08)
Abstract:
The use of once‐daily tacrolimus in de novo kidney transplantation is increasingly common. Therefore, we were interested in bioavailability aspects of novel once‐daily tacrolimus ( LCPT , Envarsus) and once‐daily tacrolimus extended‐release formulation ( ER ‐Tac, Advagraf) compared with twice‐daily immediate‐release tacrolimus ( IR ‐Tac, Prograf). Furthermore, we calculated the costs. Kidney allograft recipients on tacrolimus‐based immunosuppression within 2 clinical trials were included in a single‐center analysis. The tacrolimus formulations were compared with respect to daily doses, doses per body weight, trough levels, and concentration‐dose (C/D) ratio over 12 months. Intrapatient variability in trough levels and C/D ratios after 3 months was calculated. For the calculation of tacrolimus costs, German list prices were used. Eighty patients (21 with LCPT , 23 with IR ‐Tac, and 36 with ER ‐Tac) were analyzed. Pharmacokinetic comparisons revealed significantly higher bioavailability of LCPT at all visits. The variability of trough levels and C/D ratios in general was high and highest in LCPT patients. Different dose requirements translated into different costs. Median treatment costs during the first year were 7.825€ ( IQR 6.195‐8.892€) for LCPT , 9.813€ ( IQR 7.630‐16.832€) for IR ‐Tac, and 9.838€ ( IQR 7.503‐ 13.541€) for ER ‐Tac (Kruskal‐Wallis test, P = .003). The 3 tacrolimus formulations exhibit different dose requirements, exposure, and costs in favor of LCPT .
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
DOI:
10.1111/ctr.2018.32.issue-8
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4
