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Jeong S. Tacrolimus for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis: a potential new target of old drug? Clin Endosc 2022; 55:628-629. [PMID: 36031763 PMCID: PMC9539293 DOI: 10.5946/ce.2022.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/03/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Seok Jeong
- Division of Gastroenterology, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
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Chavant A, Fonrose X, Gautier-Veyret E, Hilleret MN, Roustit M, Stanke-Labesque F. Variability of Tacrolimus Trough Concentration in Liver Transplant Patients: Which Role of Inflammation? Pharmaceutics 2021; 13:pharmaceutics13111960. [PMID: 34834375 PMCID: PMC8623792 DOI: 10.3390/pharmaceutics13111960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/16/2022] Open
Abstract
Tacrolimus presents high intra and inter-individual variability in its blood trough concentration (Cmin). Knowledge of the factors that are involved in tacrolimus Cmin variability is thus clinically important to prevent or limit it. Inflammation can affect the pharmacokinetic properties of drugs. We evaluated the contribution of acute inflammation in the pharmacokinetic variability of tacrolimus blood Cmin in a large cohort of liver transplant patients. Demographic, biological, and clinical data from 248 liver transplant patients treated with tacrolimus from January 2010 to December 2016 were retrospectively collected from medical records. In total, 1573 Cmin/dose and concomitant C-reactive protein (CRP) measurements were analysed. In multivariate analysis, the log Cmin/dose of tacrolimus was significantly and positively associated with the hematocrit, ALAT, and CRP concentrations. CRP concentrations were higher (p = 0.003) for patients with tacrolimus overexposure (i.e., tacrolimus Cmin > 15 µg/L) (median CRP (10th–90th percentiles): 27 mg/L (3–149 mg/L), n = 91) than they were for patients with a tacrolimus Cmin ≤ 15 µg/L (13 mg/mL (3–95 mg/L), n = 1482)). CRP in the fourth quartile (49 to 334 mg/L) was associated with a 2.6-fold increased risk of tacrolimus Cmin overexposure. Our study provides evidence that inflammation contributes to tacrolimus Cmin variability and suggests that inflammation should be considered for the correct interpretation of tacrolimus blood concentration.
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Affiliation(s)
- Anaelle Chavant
- University Grenoble Alpes, HP2 INSERM U1300, 38041 Grenoble, France; (A.C.); (E.G.-V.); (M.R.)
- Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, 38043 Grenoble, France;
| | - Xavier Fonrose
- Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, 38043 Grenoble, France;
| | - Elodie Gautier-Veyret
- University Grenoble Alpes, HP2 INSERM U1300, 38041 Grenoble, France; (A.C.); (E.G.-V.); (M.R.)
- Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, 38043 Grenoble, France;
| | - Marie Noelle Hilleret
- Department of Hepato-Gastroenterology, Grenoble Alpes University Hospital, 38041 Grenoble, France;
| | - Matthieu Roustit
- University Grenoble Alpes, HP2 INSERM U1300, 38041 Grenoble, France; (A.C.); (E.G.-V.); (M.R.)
- Clinical Investigation Center, Grenoble Alpes University Hospital, 38043 Grenoble, France
| | - Francoise Stanke-Labesque
- University Grenoble Alpes, HP2 INSERM U1300, 38041 Grenoble, France; (A.C.); (E.G.-V.); (M.R.)
- Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, 38043 Grenoble, France;
- Department of Hepato-Gastroenterology, Grenoble Alpes University Hospital, 38041 Grenoble, France;
- Correspondence:
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