Effect of pantoprazole and esmoprazole on the cyclosporine blood concentration in a kideny transplant recipient / Doaa Mohamed Salah Eldian Diab El Bohy, (M.Sc. pharm. Sci. clinical pharmacy, 2012, assistant lecturer of Clinical pharmacy , faculty of pharmacy, Future university); Supervisors Manal Hamed El Hamamsy, (Ph. D. Professor of Clinical pharmacy, faculty of pharmacy, Ain Shams University), Magdy Mohamed El Sharkawy, M.D., (Professor of internal medicine & Nephrology, faculty of medicine, Ain Shams University), Soheir Abo El-Azm Diab, Ph. D., (professor of pharmacology, faculty of medicine, Cairo University), Waleed Ahmed Bchari, M.D., (Associate Professor of internal medicine & Nephrology, faculty of medicine, Ain Shams University), Sara Mahmoud Shahin, Ph. D., (Associate Professor of Clinical pharmacy, faculty of pharmacy, Ain Shams University).

Supervisors Manal Hamed El Hamamsy, (Ph. D. Professor of Clinical pharmacy, faculty of pharmacy, Ain Shams University), Magdy Mohamed El Sharkawy, M.D., (Professor of internal medicine & Nephrology, faculty of medicine, Ain Shams University), Soheir Abo El-Azm Diab, Ph. D., (professor of pharmacology, faculty of medicine, Cairo University), Waleed Ahmed Bchari, M.D., (Associate Professor of internal medicine & Nephrology, faculty of medicine, Ain Shams University), Sara Mahmoud Shahin, Ph. D., (Associate Professor of Clinical pharmacy, faculty of pharmacy, Ain Shams University).

Thesis (Ph.D.)-Ain Shams university, Faculty of pharmacy, Department of Clinical pharmacy, 2020.

Includes bibliographical references.

Renal allograft survival requires multiple immunosuppressive drugs. This strategy
may lead to gastric complications that necessitate gastro-protective medications,
notably, proton pump inhibitors (PPI). This study aimed to compare the influence
of pantoprazole and esomeprazole on serum cyclosporine trough levels (C0) in
renal transplant recipients (RTR). A prospective, parallel, open-label trial was
conducted on 47 adult RTR receiving cyclosporine doses adjusted to attain trough
concentrations of 100 to 150 μg/L, mycophenolate mofetil (MMF) 750 mg
q12 hour and prednisolone at 5 mg daily at Nasser Institute, Cairo, Egypt from
January to September 2016. Patients were randomized into the esomeprazole
group (25) or pantoprazole group (22) receiving the same dose (40 mg once daily).
The study outcomes included clinical signs of rejection and renal function
decline, assessed by elevations in serum creatinine, caused by cyclosporine level
variations in either of the two study groups. Renal function, C0 and CBC measurements were measured at baseline and monthly for 6 months. The mean C0
values were higher in the pantoprazole group than in the esomeprazole group in
the sixth month only (P = .007). Serum creatinine level was lower in the sixth
month than at baseline in the esomeprazole group (P = .004). There were no
signs of rejection biochemical or clinical in any of the study groups. In conclusion,
PPIs should be used with caution and doses should be titrated to reach the C0 targets in RTR, which is of more importance in pantoprazole than esomeprazole to
avoid C0 level elevation or decline affecting the allograft function

Text in English, abstracts in English and Arabic.