Factors Associated with Dose Modification of Lenalidomide Plus Dexamethasone Therapy in Multiple Myeloma
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- Kado Yoko
- Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University Department of Pharmacy, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Tsujimoto Masayuki
- Department of Clinical Pharmacy, Kyoto Pharmaceutical University
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- Fuchida Shin-ichi
- Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Okano Akira
- Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Hatsuse Mayumi
- Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Murakami Satoshi
- Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Sugii Hikofumi
- Department of Pharmacy, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Ueda Kumi
- Department of Pharmacy, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Toda Yuki
- Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University
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- Minegaki Tetsuya
- Department of Clinical Pharmacy, Kyoto Pharmaceutical University
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- Nishiguchi Kohshi
- Department of Clinical Pharmacy, Kyoto Pharmaceutical University
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- Muraki Yuichi
- Department of Clinical Pharmacoepidemiological, Kyoto Pharmaceutical University
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- Shimazaki Chihiro
- Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center
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- Ashihara Eishi
- Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University
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<p>Long-term combination treatment with lenalidomide and low-dose dexamethasone is important to achieve a curative effect in patients with multiple myeloma (MM). In this study, the plasma concentration of lenalidomide was measured at 3 h after oral administration, when the drug is in the elimination phase and can be easily measured in outpatients, to identify factors that may lead to the discontinuation of this combination therapy. Patients were assigned to continuation or discontinuation of therapy groups, and the baseline characteristics of patients, lenalidomide concentration, and concentration/dose (C/D) ratios reflecting oral clearance were compared between the two groups. The efficacy and severity of adverse events were also compared. The results showed that patients who discontinued or modified treatment had low plasma concentrations of lenalidomide and C/D ratios, indicating high oral clearance of lenalidomide. The estimated creatinine clearance rate was negatively correlated with the C/D ratio. The plasma concentrations of lenalidomide were independent from kidney function and differed significantly among patients. Taken together, the results indicate that low plasma concentrations of lenalidomide and low C/D ratios may lead to discontinuation of combination therapy in patients with MM. This suggests that early measurement of lenalidomide plasma continuation would help to prevent discontinuation of therapy or a delay in modifying the dose of lenalidomide.</p>
収録刊行物
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- Biological & Pharmaceutical Bulletin
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Biological & Pharmaceutical Bulletin 43 (8), 1253-1258, 2020-08-01
公益社団法人 日本薬学会
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詳細情報 詳細情報について
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- CRID
- 1390285300180206208
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- NII論文ID
- 130007883792
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- NII書誌ID
- AA10885497
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- ISSN
- 13475215
- 09186158
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- NDL書誌ID
- 030547103
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- PubMed
- 32741946
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
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- PubMed
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