TY - JOUR
T1 - The pharmacokinetics of a microemulsion formulation of cyclosporine in primary renal allograft recipients
AU - Barone, Gary
AU - Chang, Cheng Tao
AU - Choc, M. Gerry
AU - Klein, Jon B.
AU - Marsh, Christopher L.
AU - Meligeni, John A.
AU - Min, David I.
AU - Pescovitz, Mark D.
AU - Pollak, Raymond
AU - Pruett, Timothy L.
AU - Stinson, James B.
AU - Thompson, John S.
AU - Vasquez, Eva
AU - Waid, Thomas
AU - Wombolt, Duane G.
AU - Wong, Robert L.
PY - 1996/3/27
Y1 - 1996/3/27
N2 - This study was a randomized, double-blind, 12-week comparison of the pharmacokinetics, safety, and tolerability of two cyclosporine (CsA) formulations, cyclosporine emulsion capsules and oral solution for microemulsion and cyclosporine, in the postoperative management of renal transplant patients. Of the 101 patients, aged 18 to 65, who entered the study, 89 were evaluable for pharmacokinetics. Initial dosage was 10 mg/kg per day, administered twice daily in two equal doses. Dosages were adjusted to achieve target CsA concentrations. The pharmacokinetic (PK) parameters (dose-normalized) of greatest interest were maximum blood concentration (C(max)/dose), time to reach maximum concentration (t(max)), area under the blood concentration-vs.-time curve (AUC/dose), and trough blood concentrations (C(0 h)/dose). The relative CsA bioavailability was found to be significantly enhanced with cyclosporine emulsion compared with cyclosporine with a 16% to 31% increase in AUC and a 32% to 42% increase in C(max). Intrapatient variability of PK parameters was significantly lower with cyclosporine emulsion than with cyclosporine for AUC, C(0 h), t(max), and C(max) in many instances. This indicates a more consistent, rapid, and more complete total absorption of CsA. Despite higher CsA C(max) levels and AUCs with cyclosporine emulsion, safety and tolerability (detailed in a parallel report) were comparable to those of cyclosporine. The PK advantages of cyclosporine emulsion over cyclosporine are either independent of food conditions or possibly reflective of more consistent absorption of CsA with cyclosporine emulsion. The findings suggest that de novo use of cyclosporine emulsion may simplify and improve management of organ transplant recipients and that the PK advantages of cyclosporine emulsion may translate into clinical benefits.
AB - This study was a randomized, double-blind, 12-week comparison of the pharmacokinetics, safety, and tolerability of two cyclosporine (CsA) formulations, cyclosporine emulsion capsules and oral solution for microemulsion and cyclosporine, in the postoperative management of renal transplant patients. Of the 101 patients, aged 18 to 65, who entered the study, 89 were evaluable for pharmacokinetics. Initial dosage was 10 mg/kg per day, administered twice daily in two equal doses. Dosages were adjusted to achieve target CsA concentrations. The pharmacokinetic (PK) parameters (dose-normalized) of greatest interest were maximum blood concentration (C(max)/dose), time to reach maximum concentration (t(max)), area under the blood concentration-vs.-time curve (AUC/dose), and trough blood concentrations (C(0 h)/dose). The relative CsA bioavailability was found to be significantly enhanced with cyclosporine emulsion compared with cyclosporine with a 16% to 31% increase in AUC and a 32% to 42% increase in C(max). Intrapatient variability of PK parameters was significantly lower with cyclosporine emulsion than with cyclosporine for AUC, C(0 h), t(max), and C(max) in many instances. This indicates a more consistent, rapid, and more complete total absorption of CsA. Despite higher CsA C(max) levels and AUCs with cyclosporine emulsion, safety and tolerability (detailed in a parallel report) were comparable to those of cyclosporine. The PK advantages of cyclosporine emulsion over cyclosporine are either independent of food conditions or possibly reflective of more consistent absorption of CsA with cyclosporine emulsion. The findings suggest that de novo use of cyclosporine emulsion may simplify and improve management of organ transplant recipients and that the PK advantages of cyclosporine emulsion may translate into clinical benefits.
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U2 - 10.1097/00007890-199603270-00005
DO - 10.1097/00007890-199603270-00005
M3 - Article
C2 - 8623152
AN - SCOPUS:9244244130
SN - 0041-1337
VL - 61
SP - 875
EP - 880
JO - Transplantation
JF - Transplantation
IS - 6
ER -