Translational and Clinical Pharmacology

Leino Lab

The dose of medication a person receives is an important determinant of whether they experience efficacy, toxicity, or no effect at all. Most medications use a “one-size-fits-all" approach to determine the dose based on the experience of the average person in clinical trials. For some drugs, this works fine but for others it can mean the medication is not effective or side effects are common.

Our lab believes there are many examples where more precise dosing can benefit patients, particularly children who are still growing. Our mission is to improve dosing for medications that have

1. a narrow therapeutic index (the difference between efficacy and toxicity is small),
2. large variability between people in the way the body handles the drug (known as pharmacokinetics) and responds to the drug (known as pharmacodynamics), or
3. changes in drug exposure or response over time despite receiving the same dose.

Transplant medications meet all these criteria so much of our work involves people who have received a transplant.  

Precision dosing uses drug characteristics, disease knowledge, and person-specific factors to optimize drug therapy. Tailoring the dose based on this information increases the chance of treatment success while minimizing the risk of toxicity. However, much of this information must be gathered from the person taking the medication by measuring levels in the blood—sometimes repeatedly — or asking questions about how and when the medication is taken.