European Journal of Pharmaceutical Sciences 1 Januari 2025

Title	European Journal of Pharmaceutical Sciences 1 Januari 2025
Edition	1 Januari 2025
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ISBN/ISSN
Author(s)
Subject(s)	Area under the curve Cyclosporine A Trough concentration
Classification
Series Title
GMD	Jurnal
Language	Indonesia
Publisher
Publishing Year	2025
Publishing Place
Collation
Abstract/Notes	ABSTRACT Cyclosporine A (CsA) is the prevalent immunosuppressive drug for preventing and treating graft-versus-host disease after hematopoietic stem cell transplantation (HSCT) in both children and adults. Population pharma- cokinetic studies have identified covariates, owing to their large between-subject variability, facilitating indi- vidualized therapy. However, no review has summarized CsA’s population pharmacokinetics post-HSCT. This systematic review aims to synthesize population pharmacokinetic studies of CsA therapy in HSCT recipients and explore influencing covariates. Thirteen studies, comprising five involving children, one involving both children and adults and seven involving adults, were included. The median apparent clearance in children surpassed that in adults, influenced notably by hematocrit level and body. While liver function impacted clearance, the effect was insignificant. Co-administration with cytochrome P450 enzyme inhibitors (e.g., fluconazole (Diflucan) or itraconazole) decreased drug clearance, whereas inducers (e.g., rifampicin or rifapentine) increased it. Area under the curve analysis is recommended over trough concentration-based monitoring for HSCT recipients on CsA. In cases of insufficient trough concentration, additional sampling points are recommended for improved area under the curve estimation. Further studies are needed to evaluate the optimal sampling points required for the area under the curve estimation in CsA therapy post-HSCT.
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