Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/808
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dc.contributor.authorCohney, Solomon (Shlomo)-
dc.contributor.otherYates, Christopher-
dc.contributor.otherBarraclough, K. B.-
dc.contributor.otherMcWhinney, B. C.-
dc.contributor.otherUngerer, J. P. J.-
dc.contributor.otherFullinfaw, R.-
dc.contributor.otherColman, P. C.-
dc.contributor.otherFourlanos, S.-
dc.date.accessioned2016-09-28T03:40:14Z-
dc.date.available2016-09-28T03:40:14Z-
dc.date.issued2014-02-
dc.identifier.citationTher Drug Monit. 2014 Feb;36(1):18-23en_US
dc.identifier.issn1536-3694en_US
dc.identifier.issn‎0163-4356en_US
dc.identifier.urihttp://hdl.handle.net/11434/808-
dc.description.abstractBACKGROUND: Despite significant interindividual variability in prednisolone pharmacokinetics and potentially serious consequences with inadequate or excessive exposure, monitoring of prednisolone levels is not employed to guide therapy. As ultrahigh-performance liquid chromatography-tandem mass spectrometry methods can now measure the active free fraction of prednisolone, this study aimed to evaluate the performance of 15 published limited sampling strategies (LSSs) for predicting free prednisolone exposure in adult kidney transplant recipients and to examine the relationship between free/total prednisolone exposure and plasma glucose. METHODS: The study was performed in 11 subjects without diabetes 3-4 weeks postkidney transplantation. Area under the concentration time curve profiles of total and free prednisolone from 0 to 12 hours postdose (AUC₀₋₁₂) were determined and compared with predicted AUC₀₋₁₂ values calculated from published LSSs. Venous glucose was measured concurrently with the 13 sampling time points. RESULTS: The mean (±SD) age of subjects was 52 ± 12 years, 5 were men and the median (interquartile range) daily prednisolone dose was 20.0 mg (20.0-22.5). Interindividual variation in dose-adjusted free and total prednisolone exposure was 1.9- and 3.2-fold, respectively. All 15 free prednisolone LSSs exhibited good correlation (r ≥ 0.83), with bias and imprecision less than 15%. An LSS incorporating 1.25- and 3-hour samples had the highest predictive power (r = 0.97, bias 1.2%, imprecision 5.6%). Free prednisolone AUC₀₋₁₂ correlated with peak glucose levels (r = 0.65, P = 0.037), as did predicted AUC₀₋₁₂ from 14/15 LSSs. CONCLUSIONS: Biologically active free prednisolone exposure can be accurately predicted postkidney transplantation by LSSs incorporating 2-point concentration sampling. Peak plasma glucose concentration correlated well with prednisolone exposure.en_US
dc.publisherWolters Kluwer Healthen_US
dc.subjectBlood Glucoseen_US
dc.subjectBlood Specimen Collectionen_US
dc.subjectChromatographyen_US
dc.subjectHigh Pressure Liquiden_US
dc.subjectDrug Monitoringen_US
dc.subjectGlucocorticoidsen_US
dc.subjectKidney Transplantationen_US
dc.subjectPrednisoloneen_US
dc.subjectPharmacokineticsen_US
dc.subjectActive Free Fractionen_US
dc.subjectTandem Mass Spectrometryen_US
dc.subjectDepartment of Gastroenterology, Epworth HealthCare, Richmond, Victoria, Australiaen_US
dc.subjectDepartment of Nephrology, Epworth HealthCare, Richmond, Victoria, Australiaen_US
dc.titleA practical limited sampling strategy to predict free prednisolone exposure and glycemia in kidney transplant recipients.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1097/FTD.0b013e31829daae4en_US
dc.identifier.journaltitleTherapeutic Drug Monitoringen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/24335760en_US
dc.description.affiliatesDepartment of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Nephrology, University of Queensland at the Princess Alexandra Hospital, Brisbane, Queensland, Australiaen_US
dc.description.affiliatesDepartment of Chemical Pathology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australiaen_US
dc.description.affiliatesDepartments of Chemical Pathology, and Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Medicine, NorthWest Academic Centre, University of Melbourne, St Albans, Victoria, Australiaen_US
dc.type.studyortrialPredictive Testen_US
dc.type.contenttypeTexten_US
Appears in Collections:Diagnostic Services
UroRenal, Vascular

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