Modifications of doses and dosing schedules were as follows: If the neutrophil count was ≥1.5 × 10/μl and the platelet count was ≥100 × 10/μl, we would begin the next cycle for both AC and SD.
Modifications of dosing in response to ALT/AST elevations as per-protocol, led to normalisation/improvement in the majority of patients, with more methotrexate patients (four) than tocilizumab patients (one) discontinuing owing to these elevations.
In addition, because of the relative inflexibility of management options in their protocols, prior RCTs of NSAIDs have not captured the common characteristics of NSAID utilization in clinical practice, such as switching among NSAIDs (13), modifications of dosing, drug holidays, and concomitant therapies used to potentially reduce GI symptoms and complications.
Third dose monitoring is commonly used, but this does not allow early modification of dose or time interval if high concentrations are detected, particularly in those babies given once daily aminoglycosides who might have only a short 48 hour course of treatment before negative cultures are confirmed.
Such modification may be adjustment of dose, addition of another treatment (combination therapy) or switching to another therapy.
Since the pivotal PREEMPT studies, a variety of injection techniques have been proposed, with modification of doses or sites of injections.
Additional calculations were performed using the feature in OLINDA/EXM that allows modification of doses on body mass ratios to adjust the calculations to be more appropriate for the subject's individual body size.
Four major approaches are currently being explored in preclinical models, some also in patients: combination with agents that modulate cellular response and disposition of oxazaphosphorines; antisense oligonucleotides directed against specific target genes; introduction of an activating gene (CYP3A4) into tumor tissue; and modification of dosing regimens.
The authors concluded that CVVHF had little effect on micafungin kinetics, and no dose adjustment or modification of dosing interval was needed during CVVHF.
