{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:00:56Z","timestamp":1782997256852,"version":"3.54.5"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:00:00Z","timestamp":1525392000000},"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":["Euro J of Neurology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"Background and purpose<\/jats:title>Tacrolimus is beneficial for treatment of myasthenia gravis (MG<\/jats:styled-content>) and has a narrow therapeutic range. Therefore, therapeutic drug monitoring is essential for tacrolimus to optimize dosage and prevent adverse reactions. However, no studies have explored the factors influencing tacrolimus blood concentration in patients with MG<\/jats:styled-content>. Thus, we aimed to analyze these factors and discuss how to optimize tacrolimus dosage for MG<\/jats:styled-content> treatment.<\/jats:p><\/jats:sec>Methods<\/jats:title>Data regarding clinical characteristics, therapeutic drugs and adverse reactions of patients with MG<\/jats:styled-content> who received tacrolimus were collected from 2013 to 2015 at Beijing Hospital. Tacrolimus whole\u2010blood concentrations were measured by chemiluminescent microparticle immunoassay and CYP<\/jats:styled-content>3A5*3 gene polymorphism was detected by digital fluorescence molecule hybridization fluorescence. Regression analysis was applied to analyze the factors influencing blood concentrations and adverse reactions.<\/jats:p><\/jats:sec>Results<\/jats:title>It was shown that there was a correlation between concentration and dosage. Furthermore, co\u2010administration of proton pump inhibitor and clarithromycin and CYP<\/jats:styled-content>3A5*3 gene polymorphism could significantly increase the tacrolimus whole\u2010blood levels. Adverse reactions were related to blood concentration, CYP<\/jats:styled-content>3A5 genetic polymorphisms and combined medication though logistic regression analysis.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The concentration of tacrolimus is affected by many factors. Therapeutic drug monitoring and detection of CYP<\/jats:styled-content>3A5 gene polymorphism was essential for dosage optimization in patients with MG<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13652","type":"journal-article","created":{"date-parts":[[2018,4,3]],"date-time":"2018-04-03T15:52:58Z","timestamp":1522770778000},"page":"1049","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Dose optimization of tacrolimus with therapeutic drug monitoring and CYP<\/scp>3A5 polymorphism in patients with myasthenia gravis"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-4448","authenticated-orcid":false,"given":"D.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pharmacy National Center of Gerontology Beijing Hospital Beijing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurology National Center of Gerontology Beijing Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National Center of Gerontology Beijing Hospital Beijing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National Center of Gerontology Beijing Hospital Beijing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology National Center of Gerontology Beijing Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National Center of Gerontology Beijing Hospital Beijing"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285615571873"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13189"},{"key":"e_1_2_7_4_1","first-page":"934","article-title":"Neuroimmunology Association Chinese Society for Immunology. Guideline of diagnosis and treatment of myasthenia gravis in China 2015","volume":"48","author":"Neuroimmunology Group of Chinese Society of Neurology","year":"2015","journal-title":"Chin J Neurol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2298\/VSP140905005R"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3727\/215517914X681802"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2133\/dmpk.DMPK-12-RG-148"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318249b180"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/tpj.2010.42"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/tpj.2014.38"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000032"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1097\/TP.0b013e3182461288","article-title":"Genetic and clinical determinants of early acute calcineurin inhibitor related nephrotoxicity: result from a kidney transplant consortium","volume":"93","author":"Jacobsen PA","year":"2012","journal-title":"Transplantation"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/aps.2016.174"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.13652","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13652","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.13652","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13652","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T08:25:03Z","timestamp":1693729503000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.13652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,4]]},"references-count":12,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1111\/ene.13652"],"URL":"https:\/\/doi.org\/10.1111\/ene.13652","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,4]]},"assertion":[{"value":"2017-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}