Program

PO2-14-32

Rapid attainment to target trough concentrations of tacrolimus for early improvement of clinical symptoms in patients with ulcerative colitis

[Speaker] Yuto Yamada:1,2
[Co-author] Takashi Niwa:2, Hiroko Katoh:2, Akio Suzuki:2, Takashi Ibuka:3, Hiroshi Araki:3, Hideki Hayashi:1,2,4, Yoshinori Itoh:2, Tadashi Sugiyama:1,4
1:Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Japan, 2:Department of Pharmacy, Gifu University Hospital, Japan, 3:First Department of Internal Medicine, Gifu University Graduate School of Medicine, Japan, 4:Community Healthcare Pharmacy, Gifu Pharmaceutical University, Japan

Background: The target trough concentration of tacrolimus for ulcerative colitis is recommended to be 10-15 ng/mL in initial 2 weeks periods and to be 5-10 ng/mL in the later phase. However, it is still unclear whether rapid attainment to the target trough concentrations of tacrolimus is important. In the present study, we evaluated the clinical efficacy of rapid attainment to target trough concentrations of tacrolimus in patients with ulcerative colitis.
Methods: A retrospective study was conducted at Gifu University Hospital in Gifu, Japan. Hospitalized patients who received tacrolimus to treat ulcerative colitis between April 2009 and March 2016 were enrolled. Since June 2011, the initial loading dose of tacrolimus increased from 0.05 mg/kg/day to 0.1-0.2 mg/kg/day, and the maintenance dose was determined to achieve the target trough concentration at 12.5 ng/mL by proportional calculation from measured blood concentration. The period to attain target trough concentration and the clinical efficacy before and after the dosing modification were compared.
Results: A total of 30 patients were enrolled in this study, including 14 and 16 patients before and after modification, respectively. The average initial dosages before and after the modification were 0.05 (0.03-0.05) mg/kg/day and 0.1 (0.04-0.22) mg/kg/day, respectively. The period to attain the target trough concentration was significantly shortened by the modification (6 days before modification vs 4.5 days after modification, P=0.048). Moreover, The recovery period of bloody stool and diarrhea were more rapid after the dosing modification than the before. On the other hand, there were no significant differences in the incidence of other adverse events between before and after the modification.
Conclusion: These findings suggest that rapid attainment to the target trough concentrations of tacrolimus shows early improvement of clinical symptoms in patients with ulcerative colitis.

Advanced Search