Prospective Study to Assess the Optimal Blood Concentration of Tacrolimus in Japanese Patients with Rheumatoid Arthritis

We performed a prospective study to assess the optimal blood concentration of tacrolimus in Japanese patients with rheumatoid arthritis (RA). The dose of tacrolimus (1-3mg/day) was administered orally once daily after the evening meal, and the blood concentration of tacrolimus 12 hr after administra...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of Health Science Vol. 55; no. 3; pp. 435 - 440
Main Authors:	Kawazoe, Hitoshi, Dobashi, Hiroaki, Kameda, Tomohiro, Susaki, Kentaro, Kittaka, Katuharu, Tokuda, Michiaki, Fukuoka, Noriyasu, Ishida, Toshihiko, Takiguchi, Yoshiharu, Houchi, Hitoshi
Format:	Journal Article
Language:	English
Published:	Tokyo The Pharmaceutical Society of Japan 01-06-2009 Pharmaceutical Society of Japan, Nihon Yakugakkai
Subjects:	blood concentration rheumatoid arthritis tacrolimus therapeutic drug monitoring Japan
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	We performed a prospective study to assess the optimal blood concentration of tacrolimus in Japanese patients with rheumatoid arthritis (RA). The dose of tacrolimus (1-3mg/day) was administered orally once daily after the evening meal, and the blood concentration of tacrolimus 12 hr after administration was quantified. A total of 23 patients were enrolled. Clinical efficacy was assessed using the Disease Activity Score in 28 joints and European League Against Rheumatism (EULAR) response criteria at each outpatient visit during months 1-6. The ratio of patients who showed a moderate or good response was 47.8% (11/23). The mean blood concentrations of tacrolimus in EULAR responders and EULAR non-responders were 5.5±3.6 (mean±S.D.) and 3.1±1.9 ng/ml, respectively (p=0.069). Interestingly, although tacrolimus had lower mean blood concentrations (<5 ng/ml) compared with transplant fields (10-20 ng/ml), six (35.3%) of 17 patients showed sufficient response to tacrolimus. In addition, in five patients, tacrolimus was co-administered with methotrexate (MTX). On the other hand, the mean blood concentrations of tacrolimus in patients who did or did not develop adverse events were 4.8±4.4 (n=8) and 4.0±2.1 (n=15) ng/ml, respectively (p=0.624). We failed to clear the optimal blood concentration of tacrolimus in RA patients, but one of the most remarkable findings was the observation that patients in whom tacrolimus was combined with MTX reached a positive response at much lower tacrolimus concentrations compared to patients not co-treated with MTX.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1344-9702 1347-5207
DOI:	10.1248/jhs.55.435