| Mycophenolic acid in kidney transplant patients with diabetes mellitus: does the formulation matter? | |
| | |
MedLine Citation:
|
PMID: 21530217 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Diabetes mellitus is frequent in kidney transplant recipients and is commonly associated with gastrointestinal (GI) complications. Delayed gastric emptying affects 30% to 50% of patients with type 1 or 2 diabetes and can influence oral drug absorption. Time-to-peak concentration of mycophenolic acid (MPA) from mycophenolate mofetil (MMF) is longer in diabetic kidney transplant patients than patients without diabetes. By retaining gut contents in the stomach for longer, this could increase local GI toxicity in diabetic recipients due to an extended duration of exposure to MPA in the stomach. The enteric-coated mycophenolate sodium (EC-MPS) formulation delays the release of MPA until pH is higher than 5.5, such that absorption takes place more distally compared with MMF. Patient-reported outcomes data have been used to assess the effect of conversion to EC-MPS in maintenance kidney transplant patients with diabetes who were experiencing MMF-related GI symptoms. Results indicated that conversion leads to improved GI symptom burden despite higher MPA exposure under the EC-MPS regimen. Improved GI tolerance using EC-MPS has permitted maintenance of optimal MPA exposure in nondiabetic populations. Comparative trials to evaluate the GI symptom burden and maximum achieved MPA dosing using the EC-MPS and MMF formulations in de novo and maintenance diabetic kidney transplant recipients are merited. |
| | |
Authors:
|
Paul Bolin; Reginald Gohh; Raja Kandaswamy; Faud S Shihab; Anne Wiland; Fatemeh Akhlaghi; Keith Melancon |
Related Documents
:
|
20544057 - The importance and treatment of postprandial hyperglycemia. 11185847 - Disease management for diabetes mellitus: impact on hemoglobin a1c. 10926917 - Understanding and identifying monoclonal gammopathies. 2638687 - Summer camps for diabetic children in beijing of china. 16337207 - Effects of fenofibrate on apolipoprotein kinetics in patients with coexisting dysbetali... 12213907 - An atg repeat in the 3'-untranslated region of the human resistin gene is associated wi... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-4-27 |
Journal Detail:
|
Title: Transplantation reviews (Orlando, Fla.) Volume: - ISSN: 1557-9816 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-5-2 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8804364 Medline TA: Transplant Rev (Orlando) Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Nephrology and Hypertension, Brody School of Medicine, East Carolina University, NC, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Performance and coverage of HIV interventions for injection drug users: Insights from triangulation ...
Next Document: Hepatitis B virus and renal transplantation.