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Efficacy and safety of tacrolimus treatment for rheumatoid arthritis patients undergoing hemodialysis

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Modern Rheumatology

Abstract

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by progressive joint destruction that requires aggressive treatment using appropriate disease-modifying antirheumatic drugs (DMARDs). RA patients with renal failure, however, are intolerant to most DMARDs due to the potential toxicity. In Japan, tacrolimus was approved for the treatment of RA in 2005. Based on its pharmacokinetics, tacrolimus may be administered to the patients undergoing hemodialysis. We report two cases of RA patients on hemodialysis treated effectively and safely with tacrolimus.

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References

  1. Basile C, Basile C, Semeraro A. Should low-dose methotrexate therapy be prescribed to dialysis patients? Nephrol Dial Transplant. 2002;17:530–31.

    Article  PubMed  Google Scholar 

  2. Beaman JM, Hackett LP, Luxton G, Illett KF. Effect of hemodialysis on leflunomide plasma concentrations. Ann Pharmacother. 2002;36:75–7.

    Article  PubMed  Google Scholar 

  3. Iwamoto M, Homma S, Asano Y, Minota S. Administration of leflunomide to a patient with rheumatoid arthritis on haemodialysis. Scand J Rheumatol. 2005;34:410–1.

    Article  PubMed  CAS  Google Scholar 

  4. Don BR, Spin G, Nestorov I, Hutmacher M, Rose A, Kaysen GA. The pharmacokinetics of etanercept in patients with end-stage renal disease on haemodialysis. J Pharm Pharmacol. 2005;57:1407–13.

    Article  PubMed  CAS  Google Scholar 

  5. Tanaka Y, Suzuki K, Saito K. Efficacy of tacrolimus for joint destruction in rheumatoid arthritis. Clin Calcium. 2007;17:593–9.

    PubMed  CAS  Google Scholar 

  6. Venkataramanan R, Jain A, Cadoff E, Warty V, Iwasaki K, Nagase K et al. Pharmacokinetics of FK 506: preclinical and clinical studies. Transplant Proc.1990;22:52–6.

    PubMed  CAS  Google Scholar 

  7. Venkataramanan R, Jain A, Warty VW, Abu-Elmagd K, Furakawa H, Imventarza O et al. Pharmacokinetics of FK 506 following oral administration: a comparison of FK 506 and cyclosporine. Transplant Proc. 1991;23:931–3.

    PubMed  CAS  Google Scholar 

  8. Shiraga T, Matsuda H, Nagase K, Iwasaki K, Noda K, Yamazaki H et al. Metabolism of FK506, a potent immunosuppressive agent, by cytochrome P450 3A enzymes in rat, dog and human liver microsomes. Biochem Pharmacol. 1994;47:727–35.

    Article  PubMed  CAS  Google Scholar 

  9. Möller A, Iwasaki K, Kawamura A, Teramura Y, Shiraga T, Hata T et al. The disposition of 14C-labeled tacrolimus after intravenous and oral administration in healthy human subjects. Drug Metab Dispos. 1999;27:633–6.

    PubMed  Google Scholar 

  10. Furst DE, Saag K, Fleischmann MR, Sherrer Y, Block JA, Schnitzer T et al. Efficacy of tacrolimus in rheumatoid arthritis patients who have been treated unsuccessfully with methotrexate: a six-month, double-blind, randomized, dose-ranging study. Arthritis Rheum. 2002;46:2020–8.

    Article  PubMed  CAS  Google Scholar 

  11. Yocum DE, Furst DE, Bensen WG, Burch FX, Borton MA, Mengle-Gaw LJ et al. Safety of tacrolimus in patients with rheumatoid arthritis: long-term experience. Rheumatology (Oxford). 2004;43:992–9.

    Article  CAS  Google Scholar 

  12. Bressolle F, Bologna C, Kinowski JM, Sany J, Combe B. Effects of moderate renal insufficiency on pharmacokinetics of methotrexate in rheumatoid arthritis patients. Ann Rheum Dis. 1998;57:110–3.

    Article  PubMed  CAS  Google Scholar 

  13. Wall SM, Johansen MJ, Molony DA, DuBose TD, Jaffe N, Madden T. Effective clearance of methotrexate using high-flux hemodialysis membranes. Am J Kidney Dis. 1996;28:846–54.

    Article  PubMed  CAS  Google Scholar 

  14. Singh R, Cuchacovich R, Huang W, Espinoza LR. Infliximab treatment in a patient with rheumatoid arthritis on hemodialysis. J Rheumatol. 2002;29:636–7.

    PubMed  Google Scholar 

  15. Hammoudeh M. Infliximab treatment in a patient with rheumatoid arthritis on haemodialysis. Rheumatology (Oxford). 2006;45:357–9.

    Article  CAS  Google Scholar 

Download references

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Correspondence to Masamitsu Natsumeda.

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Yamashita, M., Natsumeda, M., Takasugi, K. et al. Efficacy and safety of tacrolimus treatment for rheumatoid arthritis patients undergoing hemodialysis. Mod Rheumatol 18, 296–300 (2008). https://doi.org/10.1007/s10165-008-0044-1

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  • DOI: https://doi.org/10.1007/s10165-008-0044-1

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