{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T04:09:11Z","timestamp":1767845351389,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the incidence and severity of adverse drug reactions of cyclosporine using AUC\u2010targeted therapeutic drug monitoring (TDM) compared to trough level (C<jats:sub>trough<\/jats:sub>)\u2010targeted TDM in adult allogeneic stem cell recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Blind, monocenter, intervention study. Subjects were 1:1 randomized into either an AUC group or a C<jats:sub>trough<\/jats:sub> group. Adverse drug reactions were accessed two and four weeks after start of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients were included, resulting in 15 evaluable subjects (AUC group) and 13 evaluable subjects (C<jats:sub>trough<\/jats:sub> group). Grade two\/three toxicity was observed in 46% (C<jats:sub>trough<\/jats:sub> group) versus 60% of subjects (AUC group) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.463). There was no significant difference between two and four weeks after start of cyclosporine for nausea (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.142 resp. <jats:italic>P<\/jats:italic>\u00a0=\u00a0.122), renal dysfunction (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.464 resp. <jats:italic>P<\/jats:italic>\u00a0=\u00a01.000), and hypomagnesemia (<jats:italic>P<\/jats:italic>\u00a0=\u00a01.000 resp. <jats:italic>P<\/jats:italic>\u00a0=\u00a0.411). Subjects in the AUC group reached the therapeutic goal earlier (72,7% versus 43,0% at third sampling point, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.332) and were within the target range more consistently.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed no reduction in incidence and severity of cyclosporine\u2010induced toxicity with AUC\u2010 versus trough level\u2010targeted TDM. Although modeled dosing based on AUC led to faster optimal target attainment, this did not result in less toxicity in the early days after transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13674","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T10:31:10Z","timestamp":1623407470000},"page":"364-369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["TRough versus AUC Monitoring of cyclosporine: A randomized comparison of adverse drug reactions in adult allogeneic stem cell recipients (TRAM study)"],"prefix":"10.1111","volume":"107","author":[{"given":"Marianne A.","family":"Kuijvenhoven","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacy Amsterdam University Medical Centers Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham J.","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacy Amsterdam University Medical Centers Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam University Medical Centers Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen J. 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