دورية أكاديمية

Precision sirolimus dosing in children: The potential for model-informed dosing and novel drug monitoring.

التفاصيل البيبلوغرافية
العنوان: Precision sirolimus dosing in children: The potential for model-informed dosing and novel drug monitoring.
المؤلفون: Guofang Shen, Kao Tang Ying Moua, Perkins, Kathryn, Johnson, Deron, Li, Arthur, Curtin, Peter, Wei Gao, McCune, Jeannine S.
المصدر: Frontiers in Pharmacology; 3/20/2023, Vol. 14, p1-25, 25p
مصطلحات موضوعية: DRUG monitoring, RAPAMYCIN, DRUG utilization, PHARMACOGENOMICS, FLUDARABINE, MTOR inhibitors
مستخلص: The mTOR inhibitor sirolimus is prescribed to treat children with varying diseases, ranging from vascular anomalies to sporadic lymphangioleiomyomatosis to transplantation (solid organ or hematopoietic cell). Precision dosing of sirolimus using therapeutic drug monitoring (TDM) of sirolimus concentrations in whole blood drawn at the trough (before the next dose) time-point is the current standard of care. For sirolimus, trough concentrations are only modestly correlated with the area under the curve, with R2 values ranging from 0.52 to 0.84. Thus, it should not be surprising, even with the use of sirolimus TDM, that patients treated with sirolimus have variable pharmacokinetics, toxicity, and effectiveness. Model-informed precision dosing (MIPD) will be beneficial and should be implemented. The data do not suggest dried blood spots point-of-care sampling of sirolimus concentrations for precision dosing of sirolimus. Future research on precision dosing of sirolimus should focus on pharmacogenomic and pharmacometabolomic tools to predict sirolimus pharmacokinetics and wearables for point-of-care quantitation and MIPD. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:16639812
DOI:10.3389/fphar.2023.1126981