Model-informed precision dosing to optimise immunosuppressive therapy in renal transplantation

Zwart, T.C.; Guchelaar, H.J.; Boog, P.J.M. van der; Swen, J.J.; Gelder, T. van; Fijter, J.W. de; Moes, D.J.A.R. (2021)

Article / Letter to editor

Immunosuppressive therapy is pivotal for sustained allograft and patient survival after renal transplantation. However, optimally balanced immunosuppressive therapy is challenged by between-patient and within-patient pharmacokinetic (PK) variability. This could warrant the application of personalised dosing strategies to optimise individual patient outcomes. Pharmacometrics, the science that investigates the xenobiotic-biotic interplay using computer-aided mathematical modelling, provides options to describe and quantify this PK variability and enables identification of patient characteristics affecting immunosuppressant PK and treatment outcomes. Here, we review and critically appraise the available pharmacometric model-informed dosing solutions for the typical immunosuppressants in modern renal transplantation, to guide their initial and subsequent dosing.

• Kidney transplantation
• Immunosuppressive therapy
• Personalised medicine
• Model-informed precision dosing
• Pharmacometrics
• Population pharmacokinetic modelling

• All authors: Zwart, T.C.; Guchelaar, H.J.; Boog, P.J.M. van der; Swen, J.J.; Gelder, T. van; Fijter, J.W. de; Moes, D.J.A.R.
• Date: 2021-11-01
• Journal: Drug Discovery Today
• Volume: 26
• Issue: 11
• Pages: 2527 - 2546
• DOI: doi:10.1016/j.drudis.2021.06.001
• Link: https://www.sciencedirect.com/science/article/pii/S1359644621002737?via%...