| Author/Editor | Stopinšek, Mateja; Drofenik, Polonca; Bevc, Sebastjan; Roškar, Zlatko; Holc, Iztok; Gorenjak, Maksimiljan; Mrhar, Aleš | |
| Title | Optimizacija zdravljenja s ciklosporinom v Univerzitetnem kliničnem centru Maribor | |
| Translated title | Optimising therapy with cyclosporine at the University Medical Centre Maribor | |
| Type | članek | |
| Vol. and No. | Letnik 89, št. 3/4 | |
| Publication year | 2020 | |
| Volume | str. 123-138 | |
| ISSN | 1318-0347 - Zdravniški vestnik : glasilo Slovenskega zdravniškega društva : Slovenian medical journal | |
| Language | slv | |
| Abstract | Background: Cyclosporine is an immunosuppressive drug used in transplantations and autoimmune diseases. It is a drug with a narrow therapeutic index, numerous interactions and high inter- and intraindividual variability. Therefore, therapeutic drug monitoring (TDM) and individual dosing can contribute greatly to the safety and efficacy of cyclosporine treatment. The aim of our study was to assess the importance of computerised TDM service within clinical pharmacy in the optimization of cyclosporine treatment in patients with autoimmune diseases. Methods: In 2016, we conducted a 6-month prospective study, which involved all patients on permanent cyclosporine therapy who were treated at the UMC Maribor due to autoimmune diseases. Our study was divided into two periods. i.e. the observation and the intervention period, in which the use of pharmacokinetic software DoseMe was introduced to interpret cyclosporine blood concentration measurements and to calculate the appropriate dosing regimen. There were eight patients included in the observation period and nine patients in the intervention period, six patients were monitored during both periods. By monitoring the selected parameters, the efficiency of cyclosporine treatment during both periods was compared. We used the IBM SPSS StatisticsÒ and Microsoft Office Excel for statistical analysis. Results: There were 24 measurements of cyclosporine minimum concentration (C0) carried out in the observation periodout and 18 measurements during the intervention period. The response time required for a measured concentration to be interpreted and recorded in the patient's medical record was 17.4 days during the observation period and 6.8 days during the intervention period. In both periods, one-fifth of the measured concentrations were not interpreted in patients' medical records by physicians. The percentage of cyclosporine concentration measurements that were within the therapeutic range increased from 38% to 67% during the intervention period. The number of days when patients' blood levels of cyclosporine were within the therapeutic range increased from 37.5 to 70 days. Conclusions: In this study, the importance of therapeutic drug monitoring to optimize cyclosporine treatment was confirmed. During the intervention period, the response time, the number of concentration measurements within the therapeutic range and the number of days when patients' cyclosporine blood levels were within the therapeutic range were improved. In our set of patients, DoseMe software was found to be a useful tool for optimizing cyclosporine treatment. | |
| Keywords | ciklosporin terapevtsko spremljanje koncentracij avtoimunske bolezni cyclosporine therapeutic drug monitoring autoimmune diseases |