{"id":1916,"date":"2022-09-29T15:00:32","date_gmt":"2022-09-29T07:00:32","guid":{"rendered":"https:\/\/transnovo.com\/news\/%e4%bb%96%e5%85%8b%e8%8e%ab%e5%8f%b8%e4%b8%8d%e5%90%8c%e5%88%b6%e5%89%82%e5%9c%a8%e7%a8%b3%e5%ae%9a%e8%82%be%e7%a7%bb%e6%a4%8d%e5%8f%97%e8%80%85%e4%b8%ad%e7%9a%84%e8%8d%af%e4%bb%a3%e5%8a%a8%e5%8a%9b\/"},"modified":"2022-09-29T15:00:32","modified_gmt":"2022-09-29T07:00:32","slug":"%e4%bb%96%e5%85%8b%e8%8e%ab%e5%8f%b8%e4%b8%8d%e5%90%8c%e5%88%b6%e5%89%82%e5%9c%a8%e7%a8%b3%e5%ae%9a%e8%82%be%e7%a7%bb%e6%a4%8d%e5%8f%97%e8%80%85%e4%b8%ad%e7%9a%84%e8%8d%af%e4%bb%a3%e5%8a%a8%e5%8a%9b","status":"publish","type":"post","link":"https:\/\/transnovo.com\/en\/news\/%e4%bb%96%e5%85%8b%e8%8e%ab%e5%8f%b8%e4%b8%8d%e5%90%8c%e5%88%b6%e5%89%82%e5%9c%a8%e7%a8%b3%e5%ae%9a%e8%82%be%e7%a7%bb%e6%a4%8d%e5%8f%97%e8%80%85%e4%b8%ad%e7%9a%84%e8%8d%af%e4%bb%a3%e5%8a%a8%e5%8a%9b\/","title":{"rendered":"Comparative pharmacokinetics of different formulations of tacrolimus in stable renal transplant recipients"},"content":{"rendered":"<div class='wxsyncmain'>\n<section style=\"font-size: 15px;line-height: 2;padding-right: 8px;padding-left: 8px;\" data-mpa-powered-by=\"yiban.io\">\n<section style=\"margin: 20px 0% -12px;transform: translate3d(1px, 0px, 0px);\" powered-by=\"xiumi.us\">\n<section style=\"font-size: 16px;color: rgb(255, 255, 255);text-shadow: rgb(88, 136, 195) 0px 1.8px 0px, rgb(88, 136, 195) 1.3px 1.3px 0px, rgb(88, 136, 195) 1.8px 0px 0px, rgb(88, 136, 195) 1.3px -1.3px 0px, rgb(88, 136, 195) 0px -1.8px 0px, rgb(88, 136, 195) -1.3px -1.3px 0px, rgb(88, 136, 195) -1.8px 0px 0px, rgb(88, 136, 195) -1.3px 1.3px 0px;text-align: center;letter-spacing: 3px;line-height: 1;\">\n<p><strong><span style=\"text-decoration: underline;\"><\/span><\/strong><strong>Click on the blue word to follow us<\/strong><\/p>\n<\/section>\n<\/section>\n<section style=\"margin-right: 0%;margin-bottom: 10px;margin-left: 0%;text-align: left;justify-content: flex-start;display: flex;flex-flow: row nowrap;\" powered-by=\"xiumi.us\">\n<section style=\"display: inline-block;width: 100%;vertical-align: top;background-position: 0% 0%;background-repeat: repeat;background-size: 37.1869%;background-attachment: scroll;align-self: flex-start;flex: 0 0 auto;background-image: url('http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-c945d5d7d602a6ba750ed877abba7b8e.jpeg');\">\n<section style=\"margin-top: -10px;margin-right: 0%;margin-left: 0%;text-align: justify;justify-content: flex-start;display: flex;flex-flow: row nowrap;\" powered-by=\"xiumi.us\">\n<section style=\"display: inline-block;vertical-align: top;width: 50%;align-self: flex-start;flex: 0 0 auto;\">\n<section style=\"text-align: left;\" powered-by=\"xiumi.us\">\n<section style=\"display: inline-block;width: 60px;height: 40px;vertical-align: top;overflow: hidden;line-height: 0;letter-spacing: 0px;\">\n<section style=\"text-align: center;margin-right: 0%;margin-left: 0%;\" powered-by=\"xiumi.us\">\n<section style=\"vertical-align: middle;display: inline-block;line-height: 0;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"1.019305\"  data-type=\"png\" data-w=\"259\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-ebc8f9c5e3210082a796a8b7f0499227.png\"  \/><\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<section style=\"display: inline-block;vertical-align: top;width: 50%;align-self: flex-start;flex: 0 0 auto;\">\n<section style=\"text-align: right;\" powered-by=\"xiumi.us\">\n<section style=\"display: inline-block;width: 60px;height: 40px;vertical-align: top;overflow: hidden;line-height: 0;letter-spacing: 0px;\">\n<section style=\"text-align: center;margin-right: 0%;margin-left: 0%;transform: rotateY(180deg);\" powered-by=\"xiumi.us\">\n<section style=\"vertical-align: middle;display: inline-block;line-height: 0;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"1.019305\"  data-type=\"png\" data-w=\"259\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-ebc8f9c5e3210082a796a8b7f0499227.png\"  \/><\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<p style=\"white-space: normal;\" powered-by=\"xiumi.us\"><br  \/><\/p>\n<section powered-by=\"xiumi.us\">\n<p style=\"white-space: normal;\">Tacrolimus is a component of immunosuppressive drug therapy in most renal transplant recipients, and more than 90% of renal transplant recipients receive tacrolimus-containing regimens. There are three formulations of tacrolimus used clinically after renal transplantation: traditional twice-daily immediate-release tacrolimus capsules (IR-Tac), once-daily tacrolimus extended-release capsules (ER-Tac), and once-daily tacrolimus extended-release tablets (LCPT).<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">Several previous studies have examined the pharmacokinetics, efficacy, and safety of ER-Tac and IR-Tac, and LCPT and IR-Tac separately. The following study from the United States is the first to simultaneously compare the pharmacokinetics (PK) of three different formulations of tacrolimus.<strong><span style=\"color: rgb(84, 138, 213);\">The objective of this study is to compare the pharmacokinetic profiles of IR-Tac and ER-Tac with those of LCPT in stable renal transplant recipients and to provide clinicians with a strategy for dose switching between different formulations.<\/span><\/strong><\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<\/section>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"0.3429603\"  data-type=\"png\" data-w=\"554\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-8065fa7657c6ee5a0e34b089627dad49.png\"  \/><\/section>\n<\/section>\n<section powered-by=\"xiumi.us\">\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">The study ultimately enrolled 30 eligible stable kidney transplant recipients who were randomized 1:1 to one of two treatment sequences. The IR-Tac used in the study was Procopaxil, manufactured by Astellas Pharma in the United States, the ER-Tac was Neo Procopaxil, manufactured by Astellas Pharma in the United States, and the LCPT was Envarsus XR, manufactured by Veloxis Pharmaceuticals in Europe.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">For treatment sequence 1, the study was initiated with IR-Tac for 7 days, then converted to LCPT for 7 days, then converted to ER-Tac for 7 days.<\/p>\n<p style=\"white-space: normal;\">For treatment sequence 2, the study was initiated with IR-Tac for 7 days, then converted to ER-Tac for 7 days, then converted to LCPT for 7 days.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">The total daily dose (mg) ratio for IR-Tac, ER-Tac, and LCPT conversions was 1:1:0.8. This corresponds to a reduction in the total daily dose of 20% when LCPT is used and is rounded to give the actual dose used.<strong><span style=\"color: rgb(84, 138, 213);\">Dose adjustments of immunosuppressive agents (tacrolimus, mycophenolic acid and hormones) were not allowed during the study period.<\/span><\/strong><\/p>\n<\/section>\n<p style=\"white-space: normal;\" powered-by=\"xiumi.us\"><br  \/><\/p>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"0.4802111\"  data-type=\"png\" data-w=\"379\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-bb987b2d25ffa84f4342dda9475ad4a4.png\"  \/><\/section>\n<\/section>\n<section powered-by=\"xiumi.us\">\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">At the end of each 7-day cycle, 24-hour pharmacokinetic data collection was performed.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">IR-Tac sampling strategy: C0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 12.5, 13, 13.5, 14, 14.5, 15, 16, 18, 20, and 24 h, for a total of 21 time points;<\/p>\n<p style=\"white-space: normal;\">Sampling strategy for ER-Tac and LCPT: C0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12, 14, 16, 18, 21, and 24 h, for a total of 17 time points.<\/p>\n<\/section>\n<p style=\"white-space: normal;\" powered-by=\"xiumi.us\"><br  \/><\/p>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"0.570632\"  data-type=\"png\" data-w=\"538\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-7e697014fe9996a664e8a85789e3b685.png\"  \/><\/section>\n<\/section>\n<section powered-by=\"xiumi.us\">\n<p style=\"text-align: center;white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">Figure A shows the whole blood concentration and PK profiles of the three tacrolimus formulations. (IR-Tac, ER-Tac, LCPT conversion standardized to 1:1:0.8)<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">AUC of LCPT<sub style=\"font-size: 12px;\">0-24<\/sub>, significantly higher than IR-Tac (RGM: 117.0%; p = 0.002), and ER-Tac (RGM: 125.7%; p &lt; 0.001).<\/p>\n<p style=\"white-space: normal;\">The peak-to-valley fluctuations of LCPT were significantly lower than those of IR-Tac (LSM difference: -29.0%; p = 0.004), and ER-Tac (LSM difference: -35.3%; p &lt; 0.001).<\/p>\n<p style=\"white-space: normal;\">LCPT's T<sub style=\"font-size: 12px;\">max<\/sub>up to 5.9 hours, significantly longer than IR-Tac (1.9 hours; p &lt; 0.001) and ER-Tac (1.5 hours; p &lt; 0.001).<\/p>\n<p style=\"white-space: normal;\">C of ER-Tac<sub>min<\/sub>was 5.1 ng\/mL, significantly lower than IR-Tac (6.1 ng\/mL, p = 0.001) and LCPT (6.8 ng\/mL, p &lt; 0.001)).<\/p>\n<p style=\"white-space: normal;\"><strong><span style=\"color: rgb(84, 138, 213);\">between IR-Tac and ER-Tac in addition to C<sub style=\"font-size: 12px;\">min<\/sub>differences and no statistically significant differences in other PK parameters (Table 1).<\/span><\/strong><\/p>\n<\/section>\n<p style=\"white-space: normal;\" powered-by=\"xiumi.us\"><br  \/><\/p>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"0.4117647\"  data-type=\"png\" data-w=\"476\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-8db2fe05290f1ef998eea398a22b0842.png\"  \/><\/section>\n<\/section>\n<section powered-by=\"xiumi.us\">\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">According to the conversion criteria set by the study (1:1:0.8 conversion criteria for IR-Tac, ER-Tac, and LCPT), LCPT had greater relative bioavailability compared to IR-Tac and ER-Tac, with an increase of approximately 501 TP3T (p&lt;0.001). The dose conversion rates set in accordance with the study resulted in significantly higher total exposure to LCPT. In contrast, the difference in total exposure rate was not significant when switching between IR-Tac and ER-Tac (RGM: 93.11 TP3T; p=0.149).<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">The researchers then performed exposure normalization and dose conversion analyses (Figure B).<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">IR-Tac was converted to LCPT according to 1:0.7, and similar AUCs were obtained<sub style=\"font-size: 12px;\">0-24<\/sub>(RGM: 102.41 TP3T; p=0.627).<\/p>\n<p style=\"white-space: normal;\">ER-Tac was converted to LCPT according to 1:0.64, yielding similar AUCs<sub style=\"font-size: 12px;\">0-24<\/sub>(RGM: 100.6%; p=0.924).<\/p>\n<p style=\"white-space: normal;\">IR-Tac was converted to ER-Tac according to 1:1.08, which gave a similar AUC<sub style=\"font-size: 12px;\">0-24<\/sub>(RGM: 100.6%; p=0.908).<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">At the same time, LCPT's C<sub>max<\/sub>reduced 17%, while ER-Tac and IR-Tac C<sub style=\"font-size: 12px;\">max<\/sub>remained similar (p = 0.887).<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<\/section>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-ratio=\"0.5576208\"  data-type=\"png\" data-w=\"538\" style=\"vertical-align: middle;width: 100%;box-sizing: border-box;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-b8c38abf9f462548f1c2d59f3b7b2a81.png\"  \/><\/section>\n<\/section>\n<p style=\"white-space: normal;\" powered-by=\"xiumi.us\"><br  \/><\/p>\n<section powered-by=\"xiumi.us\">\n<p style=\"white-space: normal;\">In addition.<strong><span style=\"color: rgb(84, 138, 213);\">This study found that the AUC of three tacrolimus formulations<sub style=\"font-size: 12px;\">0-24<\/sub>and C<sub style=\"font-size: 12px;\">min<\/sub>There is a strong correlation between<\/span><\/strong>The ln (AUC) of LCPT<sub style=\"font-size: 12px;\">0-24<\/sub>) and ln(C<sub style=\"font-size: 12px;\">min<\/sub>) The Pearson linear correlation coefficients between were 0.92 (p &lt; 0.001) for ER-Tac and 0.81 (p &lt; 0.001) for IR-Tac.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">In this study, LCPT showed higher systemic exposure to tacrolimus and more pronounced bioavailability.The PK curve for LCPT was flatter, with less fluctuation between trough and peak concentrations, and a longer time to reach peak concentrations. The clinical significance of this finding remains to be fully explored, but may help to reduce tacrolimus toxicity associated with peak concentration levels.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">When converted from IR-Tac to ER-Tac according to 1:1, the trough concentration of ER-Tac was significantly lower and the overall exposure was reduced compared to IR-Tac. When exposure normalization analyses were performed, the characteristic peak after initial IR-Tac administration was also observed in ER-Tac.The PK curves of ER-Tac and IR-Tac tended to be similar.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">Based on the results of this study and exposure normalization analyses, a reduction of 361 TP3T in total daily medication is recommended when switching from ER-Tac to LCPT, and a reduction of 301 TP3T is recommended when switching from IR-Tac to LCPT. an increase of 81 TP3T in total medication is recommended when switching from IR-Tac to ER-Tac. (Although the available medication dosage forms may limit the precise switch. information, it is still helpful in achieving the target exposure for tacrolimus when switching between formulations.)<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">Currently available tacrolimus formulations in the country are IR-Tac and ER-Tac.This study may provide clinicians with some strategies for drug utilization. When IR-Tac and ER-Tac were used in a 1:1 fashion, there was a significant reduction in trough concentrations of ER-Tac (p = 0.001) and a reduction in overall exposure (RGM: 93.11 TP3T; p = 0.149) compared to IR-Tac. Conversion from IR-Tac to ER-Tac required an increase of 81 TP3T in the total amount of drug.The characteristic peaks of IR-Tac, which also occur in ER-Tac, tended to be similar in the PK curves of ER-Tac and IR-Tac.Whether similar peak concentration levels of ER-Tac and IR-Tac are associated with similar tacrolimus toxicity needs to be further explored.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<p style=\"white-space: normal;\">Finally, the study did not assess the effect of recipient genotype on PK of tacrolimus formulations.<\/p>\n<p style=\"white-space: normal;\"><br  \/><\/p>\n<\/section>\n<section style=\"text-align: center;margin-top: 0.5em;margin-bottom: 0.5em;padding-left: 0.5em;padding-right: 0.5em;\" powered-by=\"xiumi.us\">\n<section style=\"width: 100%;box-shadow: rgb(102, 102, 102) 3.2px 3.2px 8px;display: inline-block;line-height: 0;border-color: white;height: auto !important;\"><img decoding=\"async\" class=\"rich_pages wxw-img\" data-cropselx1=\"0\" data-cropselx2=\"547\" data-cropsely1=\"0\" data-cropsely2=\"684\" data-ratio=\"1.4151681000781862\"  data-type=\"jpeg\" data-w=\"1279\" style=\"vertical-align: middle;width: 547px;box-sizing: border-box;height: 774px;\" src=\"http:\/\/transnovo.com\/wp-content\/uploads\/2023\/05\/wxsync-2023-05-16865c161f1fecf6d88a0e561a080beb.png\"  \/><\/section>\n<\/section>\n<\/section>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>\u70b9\u51fb\u84dd\u5b57\u5173\u6ce8\u6211\u4eec \u4ed6\u514b\u83ab\u53f8\u662f\u5927\u591a\u6570\u80be\u79fb\u690d\u53d7\u8005\u514d\u75ab\u6291\u5236\u836f\u7269\u6cbb\u7597\u7684\u4e00\u4e2a\u7ec4\u6210\u90e8\u5206\uff0c\u8d85\u8fc790%\u7684\u80be\u79fb\u690d\u53d7\u8005\u63a5\u53d7\u542b\u4ed6\u514b\u83ab [&hellip;]<\/p>","protected":false},"author":6,"featured_media":1908,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.5 - 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