臨床泌尿器科69巻13号

2015年12月発行

特集 知っておきたい腎移植の最新情報—基礎から臨床まで

Ⅴ．免疫抑制法とTDM

免疫抑制薬TDMの重要性

著者： 渡井至彦¹

所属機関： ¹名古屋第二赤十字病院移植外科

ページ範囲：P.1153 - P.1164

文献概要

要旨　免疫抑制薬はNTI（narrow therapeutic index drugs）に分類され，通常の薬剤に比較して効果が得られつつ副作用を起こしにくい薬物の血中濃度の幅が非常に狭いことからTDM（therapeutic drug monitoring）が必要な薬剤と考えられている。腎移植後の免疫抑制療法は，導入療法（抗CD25抗体など）にCNI（CsA・TAC）と代謝拮抗薬（MMF，EVR，Mizoribin）±低用量ステロイドを組み合わせる多剤併用療法が標準である。免疫抑制薬同士や免疫抑制薬以外の併用薬との相互作用を熟知し，各薬剤に適したTDMによって適切な投与量設計を行うことが現在において安全にかつ効果的に使用する唯一の方法である。

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