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CURATE.AI - AI-derived personalized tacrolimus dosing for pediatric liver transplant: A retrospective study

Tan, S.-B.; Kumar, K. S.; Gan, T. R. X.; Truong, A. T. L.; Tan, L. W. J.; Blasiak, A.; Mali, V. P.; Aw, M. M.; Ho, D.

2022-11-24 pharmacology and therapeutics
10.1101/2022.11.24.22282708 medRxiv
Show abstract

Tacrolimus is the cornerstone of immunosuppressive therapy after pediatric liver transplantation. However, reliance on the physicians experience for dose titration, coupled with tacrolimuss narrow therapeutic window and inter and intra-patient variability, often results in frequent under or over-dosing with detrimental patient outcomes. Existing predictive dose personalization models are not readily feasible for clinical implementation, as they require multiple measurements each day while the standard frequency is once daily. We developed CURATE.AI, a small-data artificial intelligence-derived platform, as a clinical decision support system to personalize doses using the patients own data obtained once a day. Retrospective dose personalization with CURATE.AI on 16 patients data demonstrated potential to enable patients to stay in the therapeutic range longer and reach the therapeutic range significantly earlier. Our findings support the testing of CURATE.AI in a prospective controlled trial as an aid for the physicians decision on tacrolimus dose personalization after pediatric liver transplantation.

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