Comparing weight‐based dosing of tacrolimus XR in obese and non‐obese renal transplant recipients. Issue 2 (24th November 2021) - Breslin, Nadine T.
Abstract: The recommended initial weight‐based dose of extended‐release (XR) tacrolimus (Envarsus XR) in kidney transplant recipients (KTR) is 0.14 mg/kg/day. However, no data exist regarding dosing recommendations for obese patients specifically. The aim of this study was to evaluate weight‐based dosing requirements in a cohort of obese KTR who were initiated on de novo tacrolimus XR post‐transplantation. The primary outcome was weight‐based dosing requirements (mg/kg/day) on post‐operative day (POD) 7 and 14. Of the 254 KTR, 81 (31%) were obese. The median therapeutic dose on POD7 was 0.1 versus 0.12 vs. 0.14 mg/kg/day in the BMI > 30 kg/m 2, BMI 25–30 kg/m 2, and BMI < 25 kg/m 2, respectively, ( p = .0001). This result was similar on POD14; median therapeutic dose was 0.09 versus 0.11 versus 0.15 mg/kg/day in the BMI > 30 kg/m 2, BMI 25–30 kg/m 2, and BMI < 25 kg/m 2, respectively, ( p < .001). Therapeutic dose on POD7 and POD14 based on ideal body was similar in all cohorts ( p = .238, p = .923, respectively). This finding was supported by a strong linear relationship between ideal body weight (IBW) and therapeutic dose ( r = .929). In both obese and non‐obese KTR, IBW had a stronger correlation with the therapeutic dose for tacrolimus XR.