Individualisation of leflunomide dosing in rheumatoid arthritis patients /
| dc.contributor.author | Hopkins, Ashley Mark, | |
| dc.contributor.school | University of South Australia. School of Pharmacy and Medical Sciences. | |
| dc.contributor.school | School of Pharmacy and Medical Sciences. | |
| dc.date.issued | 2016 | |
| dc.description | 1 ethesis (xxiv, 275 pages) : | |
| dc.description | illustrations (some colour) | |
| dc.description | Includes bibliographical references (pages 155-171) | |
| dc.description.abstract | Historically, leflunomide has been a second-line disease modifying anti-rheumatic drug (DMARD), initiated in those who fail to respond to methotrexate-based therapies. Nowadays, those who fail to respond to leflunomide tend to progress to expensive biological agents. Leflunomide’s therapeutic effects occur through the inhibition of the mitochondrial enzyme dihydro-oroate dehydrogenase within T-lymphocytes by its active metabolite, teriflunomide. Given teriflunomide has highly variable pharmacokinetics between individuals (that may be influenced by pharmacogenetic variants), relatively consistent within individual pharmacokinetic variability and there is a documented concentration-response relationship, leflunomide appears to be an ideal candidate for personalised dosing strategies. The aim of this thesis was to review leflunomide’s place in therapy and assist the development of individualisation strategies for leflunomide dosing in rheumatoid arthritis (RA) patients, thereby minimising the wide variability in response and toxicity to therapy. To achieve this, qualitative and pharmacoepidemiological studies were conducted to investigate treatment strategies employed by Australian rheumatologists, while novel variants and pharmacometric modelling techniques were explored to assist the development of individualisation strategies for leflunomide. | |
| dc.description.dissertation | Thesis (PhD)--University of South Australia, 2016. | |
| dc.identifier.uri | https://hdl.handle.net/11541.2/122693 | |
| dc.language.iso | en | |
| dc.provenance | Copyright 2015 Ashley Hopkins | |
| dc.subject.lcsh | Leflunomide | |
| dc.subject.lcsh | Rheumatoid arthritis | |
| dc.title | Individualisation of leflunomide dosing in rheumatoid arthritis patients / | |
| dc.type | thesis | |
| dcterms.accessRights | 506 0#$fstar $2Unrestricted online access | |
| ror.fileinfo | 12195059890001831 13203197830001831 9916103510501831_53139758920001831 | |
| ror.mmsid | 9916103510501831 |
Files
Original bundle
1 - 1 of 1
No Thumbnail Available
- Name:
- 9916103510501831_53139758920001831.pdf
- Size:
- 8.86 MB
- Format:
- Adobe Portable Document Format
- Description:
- Published version