Measurement of the Immunosuppressant Possession Ratio by Transplant Clinical Pharmacists Captures a Non-Adherence Associated With Antibody-Mediated Rejection. - Biology of Cardiovascular Diseases Accéder directement au contenu
Article Dans Une Revue Transplant International Année : 2023

Measurement of the Immunosuppressant Possession Ratio by Transplant Clinical Pharmacists Captures a Non-Adherence Associated With Antibody-Mediated Rejection.

Résumé

Our objective was to calculate an immunosuppressant possession ratio (IPR) to diagnose non-adherence at the time of antibody-mediated rejection (ABMR). IPR was defined as the ratio of number of pills collected at the pharmacy to the number of pills prescribed over a defined period. In a first cohort of 91 kidney transplant recipients (KTRs), those with an IPR 30% than patients with an IPR = 100% (66.7% vs. 29.4%, = 0.05). In a case-control study, 26 KTRs with ABMR had lower 6 months IPRs than 26 controls (76% vs. 99%, < 0.001). In KTRs with ABMR, non-adherence was more often diagnosed by a 6 months IPR < 90% than by clinical suspicion (73.1% vs 30.8%, = 0.02). In the multivariable analysis, only DSA and 6 months IPR < 90% were independently associated with ABMR, whereas clinical suspicion was not (odds ratio, 4.73; 95% CI, 1.17-21.88; = 0.03; and odds ratio, 6.34; 95% CI, 1.73-25.59; = 0.007, respectively). In summary, IPR < 90% is a quantifiable tool to measure immunosuppressant non-adherence. It is better associated with ABMR than clinical suspicion of non-adherence.
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hal-04500021 , version 1 (11-03-2024)

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Jeremy Chambord, Bertrand Chauveau, Sarah Djabarouti, Jean Vignaud, Benjamin Taton, et al.. Measurement of the Immunosuppressant Possession Ratio by Transplant Clinical Pharmacists Captures a Non-Adherence Associated With Antibody-Mediated Rejection.. Transplant International, 2023, 36, pp.11962. ⟨10.3389/ti.2023.11962⟩. ⟨hal-04500021⟩

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