Klinički aspekti terapijskog praćenja ciklosporina u pedijatrijskoj populaciji pacijenata sa transplantiranim bubregom
Sažetak
Ciklosporin A (CsA) je imunosupresiv koji se koristi kod dece i odraslih pacijenata sa transplantiranim organom, kao i kod pacijenata sa autoimunim bolestima kao što je nefrotski sindrom. Terapijsko praćenje ciklosporina (TDM) je ključno za optimizaciju terapije zbog velike interindividualne i intraindividualne farmakokinetičke varijabilnosti, uskog terapijskog indeksa, rizika od odbacivanja organa ili recidiva autoimune bolesti ukoliko su nivoi CsA preniski, ili pojave neželjenih efekata usled prekomerne izloženosti leku. Kod dece, farmakokinetika CsA može biti izmenjena zbog razvojnih fizioloških faktora, tako da treba posvetiti više pažnje sprovođenju TDM u ovoj osetljivoj populaciji. U ovom radu biće opisani ključni izazovi sprovođenja TDM u pedijatrijskoj populaciji, razlog zbog koga se i kada sprovodi u kliničkoj praksi, kao i savremene strategije za optimizaciju terapije kao što je doziranje zasnovano na upotrebi modela.
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