Hypothesis : In renal transplantation recipient who received immunosuppressive drug "certican" and have hypercholesterolemia will get lipid lower drug-HMG Co-A reductase inhibitors. Because atorvastatin and everolimus have metabolism via Cytochrome P450 subfamily 3A4 both, so investigator made the hypothesis that when patients received everolimus with atorvastatin will change area under the time concentration curve of everolimus.
Population : Thai postrenal transplantation recipient who received everolimus and have hypercholesterolemia in posttransplantation clinic at Faculty of Medicine, Chulalongkorn University. Study Design : Experimental study, Two-sample crossover study Sample size calculation :N = 18 Primary outcome : 12-hour area under the time concentration curve of everolimus Secondary outcome : renal function (serum creatinine, creatinine clearance) Method : 1. Patients will random to everolimus or everolimus with atorvastatin 20 mg arm for 1 month. 2. Take blood sample for everolimus concentration at time 0,0.5, 1, 1.5, 2, 2.5, 4, 6, 8, 12 hour 3. After first blood sample, patients will received everolimus only for 1 month (wash out period) 4. Patients will switch to another arm eg.patient who had received everolimus will switch to everolimus with atorvastatin 20 mg for 1 month 5. Take blood sample for everolimus concentration at time 0,0.5, 1, 1.5, 2, 2.5, 4, 6, 8, 12 hour 6. Everolimus level will analyse for 12-hour AUC of everolimus.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
18
Add atorvastatin 20 mg and compare 12-hour AUC of everolimus between Arm everolimus and everolimus with atorvastatin 20 mg
Administration only everolimus, no atorvastatin. Everolimus administration with adjusted dose to target C trough (C0)level between 3-12 ng/mL.
King Chulalongkorn Memorial Hospital
Bangkok, Bangkok, Thailand
12-hour area under the time concentration curve of everolimus
compare when taking only everolimus to coadministered with atorvastatin
Time frame: 3 months
Renal function
Renal function : serum creatinine, 24 hour creatinine clearance 24 hour urine protein, Urinalysis Sample take at month 0,1,2,3
Time frame: 3 months
Liver function test
Total protein, Albumin, total bilirubin, direct bilirubin, AST, ALT, Alkaline phosphatase at month 0,1,2,3
Time frame: 3 month
Lipid profile
Total cholesterol, Triglyceride, HDL, LDL at month 0,1,2,3
Time frame: 3 month
Rhabdomyolysis
Adverse drug reaction from atorvastatin by measured CPK at month 0,1,2,3
Time frame: 3 month
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