Diminution du risque de rejet chronique et de variabilité de lʼabsorption avec Néoral® par rapport à Sandimmun®

The inter- and intrapatient variability in cyclosporin pharmacokinetics obfuscates the relationship between therapeutic outcome and administered dose. We defined patients with high pharmacokinetic variability and an increased risk of chronic rejection by means of serial pharmacokinetic profiling of 204 renal transplant patients treated for up to 5 years with cyclosporin doses selected to achieve a target average cyclosporin concentration (Cav). Patients were stratified into cohorts according to high versus low pharmacokinetic variability, which was based on the cut-off values of percentage coefficient of variation (%CV) of the dose-corrected Cav (Cav/mg; 35%) or 0-hour concentration (C0/mg; 53%). These values are the inflection points of curves that express the relationships between true positives (patients with high %CV and chronic rejection) versus false positives (patients with high %CV but no evidence of chronic rejection).