Method and system for use in treating a patient with immunosuppresants using whole blood level criteria to prevent an adverse immune response
First Claim
1. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the immune system to combat infection, comprising the step of:
- (a) administering an initial dose of an immunosuppressant to the patient;
(b) examining the patient to determine information concerning patient examination criteria, wherein the patient examination criteria comprises toxicity and a blood level of the immunosuppressant;
(c) assigning a characterization to each of the patient examination criteria, each such characterization being selected from a predetermined standardized range of characterizations applicable to each patient examination criterion;
(d) providing the assigned characterizations to a computing device comprising;
a knowledge base comprising rules which include one of a plurality of treatment instructions in response to at least one of various combinations of the characterizations which can be assigned to the patient examination criteria, andan expert computer program including a first routine for prompting, through an output means, a user to enter, through an input means, the assigned characterizations;
a second routine for selecting a treatment instruction by locating a rule which covers the assigned characterizations, and thereby determines the treatment instruction; and
a third routine for communicating the treatment instruction to the output means;
(e) receiving from the computing device the treatment instruction; and
(f) administering a next dose of the immunosuppressant to the patient in accordance with the treatment instruction.
2 Assignments
0 Petitions
Accused Products
Abstract
A method and system for use in treating a patient with an immunosuppressant to prevent an adverse immune response, either a rejection of a transplanted organ or an attack on the patient'"'"'s body by its own immune system caused by an autoimmune disease, without unduly suppressing the ability of the patient'"'"'s immune system to combat infection. The method employs an expert system to provide non-numerical information concerning the course of action to be taken with respect to a patient'"'"'s immunosuppressant treatment, at a given time, including, in particular, an instruction on whether the immunosuppressant dosage being administered to the patient should be changed, and if so how. That instruction is determined by the expert system through analysis of standardized characterizations assigned to standardized patient examination criteria including levels of the immunosuppressant in blood plasma and whole blood. The method also employs a means for determining the actual numerical immunosuppressant dosage the patient should receive at a given time.
26 Citations
32 Claims
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1. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the immune system to combat infection, comprising the step of:
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(a) administering an initial dose of an immunosuppressant to the patient; (b) examining the patient to determine information concerning patient examination criteria, wherein the patient examination criteria comprises toxicity and a blood level of the immunosuppressant; (c) assigning a characterization to each of the patient examination criteria, each such characterization being selected from a predetermined standardized range of characterizations applicable to each patient examination criterion; (d) providing the assigned characterizations to a computing device comprising; a knowledge base comprising rules which include one of a plurality of treatment instructions in response to at least one of various combinations of the characterizations which can be assigned to the patient examination criteria, and an expert computer program including a first routine for prompting, through an output means, a user to enter, through an input means, the assigned characterizations;
a second routine for selecting a treatment instruction by locating a rule which covers the assigned characterizations, and thereby determines the treatment instruction; and
a third routine for communicating the treatment instruction to the output means;(e) receiving from the computing device the treatment instruction; and (f) administering a next dose of the immunosuppressant to the patient in accordance with the treatment instruction. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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24. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the immune system to combat infection, comprising the steps of:
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(a) administering an initial dose of an immunosuppressant to the patient; (b) examining the patient to determine a current immunosuppressant whole blood level for the patient; (c) assigning a characterization to the patient'"'"'s current immunosuppressant whole blood level from a predetermined standardized range of characterizations; (d) providing the patient'"'"'s current immunosuppressant dosage and the characterization assigned to the patient'"'"'s current immunosuppressant whole blood level to a computing device comprising; a knowledge base comprising rules which include one of a finite number of values for a decreased next immunosuppressant dosage in response to at least one of various combinations of characterizations which can be assigned to the patient'"'"'s current immunosuppressant whole blood level and values for the patient'"'"'s current immunosuppressant dosage; and an expert computer program including a first routine for prompting, through an output means, a user to enter, through an input means, the patient'"'"'s current dosage and the characterization assigned to the patient'"'"'s current immunosuppressant whole blood level;
a second routine for selecting the next immunosuppressant dosage by locating the rule which covers the patient'"'"'s current immunosuppressant dosage and the characterization assigned to the patient'"'"'s current immunosuppressant whole blood level, and thereby determines the decreased next immunosuppressant dosage; and
a third routine for communicating the decreased next immunosuppressant dosage to the output means;(e) receiving from the computing device the decreased next immunosuppressant dosage; and (f) administering a next immunosuppressant dose in accordance with the decreased next immunosuppressant dosage determined by the computing device. - View Dependent Claims (25, 26, 27, 28, 29)
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30. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the immune system to combat infection, comprising the steps of:
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(a) administering an initial dose of FK 506 to the patient; (b) examining the patient to determine a current FK 506 whole blood level for the patient; (c) determining a desired FK 506 level for the patient; (d) employing the following relationship along with the patient'"'"'s current FK 506 dosage, the patient'"'"'s current FK 506 whole blood level, and the desired FK 506 level for the patient to determine a next FK 506 dosage;
space="preserve" listing-type="equation">ND=CD-((((CL-DL)/CL)/(1+(CD/40)))/CD)+((0.2×
CD)×
(((1+d)-(1+e))/abs((1+d))))wherein ND=the next FK 506 dosage CD=the patient'"'"'s current FK 506 dosage, CL=the patient'"'"'s current FK 506 whole blood level, DL=the desired FK 506 level for the patient, RD=the patient'"'"'s previous FK 506 whole blood level e=CL-RD d=DL-RD (e) administering a next dose of FK 506 to the patient in accordance with the next FK 506 dosage determined from the relationship.
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31. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the immune system to combat infection, comprising the steps of:
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(a) administering an initial dose of Rapamycin to the patient; (b) examining the patient to determine a current Rapamycin whole blood level for the patient; (c) determining a desired Rapamycin level for the patient; (d) employing the following relationship along with the patient'"'"'s current Rapamycin dosage, the patient'"'"'s current Rapamycin whole blood level, and the desired Rapamycin level for the patient to determine a next Rapamycin dosage;
space="preserve" listing-type="equation">ND=CD-((((CL-DL)/CL)/(1+(CD/30)))/CD)+((0.2×
CD)×
(((1+d)-(1+e))/abs((1+d))))wherein, ND=the next RPM dosage, CD=the patient'"'"'s current RPM dosage, CL=the patient'"'"'s current RPM whole blood level, DL=the desired RPM whole blood level for the patient, RD=the patient'"'"'s previous RPM whole blood level, e=CL-RD, and d=DL-RD. (e) administering a next dose of Rapamycin to the patient in accordance with the next Rapamycin dosage determined from the relationship.
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32. A method for treating a patient to prevent an adverse immune response by partially suppressing the patient'"'"'s immune system without unduly suppressing the ability of the system to combat infection, comprising the steps of:
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(a) administering an initial dose of Cyclosporin to the patient; (b) examining the patient to determine a current Cyclosporin whole blood level for the patient; (c) determining a desired Cyclosporin level for the patient; (d) employing the following relationship along with the patient'"'"'s current Cyclosporin dosage, the patient'"'"'s current Cyclosporin whole blood level, and a potential next Cyclosporin dosage to determine a next Cyclosporin dosage;
space="preserve" listing-type="equation">ND=CD-((((CL-DL)/CL)/(2.5+(CD/1500)×
2.5))/CD)+((0.2×
CD)×
(((1+d)-(1+e))/abs((1+d))))wherein, ND=the patient'"'"'s next Cyclosporin dosage, CD=the patient'"'"'s current Cyclosporin dosage, CL=the patient'"'"'s current Cyclosporin whole blood level, and DL=the desired Cyclosporin level for the patient, RD=the patient'"'"'s previous Cyclosporin whole blood level e=CL-RD d=DL-RD (e) administering a next dose of Cyclosporin to the patient in accordance with the next Cyclosporin dosage determined from the relationship.
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Specification