Since its discovery in 1970, and introduction into clinical practice in 1978, cyclosporin has become the most important immunosuppressive drug used to prevent organ transplant rejection.
This has been achieved by virtue of the improved graft survival rates and adverse effect profiles in patients when compared with that of the older agents.
Cyclosporin is substantially more expensive (both to provide and to monitor) however, and the magnitude of these costs may preclude its use, particularly where the transplant recipient is required to pay.
Cyclosporin has a complex pharmacokinetic profile with poor absorption, extensive metabolism to more than 30 metabolites and considerable inter-and intrapatient variability.
Many transplant centres routinely use drugs ('cyclosporin-sparing agents') to allow a reduction in the dosage of cyclosporin while maintaining therapeutic blood cyclosporin concentrations.
The use of a second drug to affect the pharmacokinetic profile of a primary drug is not new, but the use of cyclosporin-sparing agents is a departure from previous practices in that this coprescription is primarily for economic reasons.
The decision to use these agents (and the choice of agent) is based upon economic and other factors including the extent of the cyclosporin-sparing effect, the potential for additional therapeutic benefit and/or adverse effects. (...)
Mots-clés Pascal : Ciclosporine, Immunodépresseur, Association médicamenteuse, Interaction médicamenteuse, Pharmacocinétique, Activité biologique, Analyse coût, Economie santé, Homme
Mots-clés Pascal anglais : Ciclosporin, Immunosuppressive agent, Drug combination, Drug interaction, Pharmacokinetics, Biological activity, Cost analysis, Health economy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0289915
Code Inist : 002B02Q. Création : 15/07/1997.