SIROLIMUS (RAPAMUNE)

Code
900.3955
Name
SIROLIMUS (RAPAMUNE)
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Rapamune; Rapamycin;Immunosuppressant
CPT Codes
80195
Site
SBMF
Reference Test
30064
ATLAS Test Code

Specimen Information

Type

Lavender, EDTA, WHOLE BLOOD

Volume

1.0 ml

Transport Info

Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Therapeutic range: 5.0-15.0 ng/mL

Methodology

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Clinical Significance

Aid in management of renal transplant patients receiving Sirolimus immunosuppressive treatment.

Sirolimus (Rapamune, Rapamycin) is an immunosuppressive drug used for renal transplant immunosuppressive therapy. Sirolimus is a macrocyclic lactone fermentation product of Stretomyces hygroscopicus. It exhibits a synergistic action with calcineurin inhibitors. It binds to the immunophillin FK-binding protein 12, and the resulting complex binds to a specific cell-cycle regulatory protein mTOR and inhibits its activation. The inhibition of mTOR results in suppression of cytokine-driven T-lymphocyte proliferation, inhibiting the progression from G1 to the S phase of the cell cycle. A good correlation of trough concentration to area under the concentration time curve (AUC) was found and a strong correlation between the evidence of toxicity and high trough concentrations has been reported. Therefore, trough concentration measurement provides a useful index of total drug exposure during the dosing interval. Sirolimus results measured by MEIA were found to be higher than those reported by the previous method, High Performance Liquid Chromatography (HPLC). The following correlation statistics were observed by studying over 200 renal transplant patients who were under Sirolimus treatment: MEIA = 1.232(HPLC) – 0.28 r = 0.929.

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