Document Detail


The need of mycophenolic acid monitoring in long-term renal transplants.
MedLine Citation:
PMID:  15659129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is little information regarding the 12-h mycophenolic acid (MPA) pharmacokinetics (PK), a way to monitor the drug and the need of frequent monitoring, in stable patients.
METHODS: A cohort of 35 adults, under long-term mycophenolate mofetil (MMF) therapy plus cyclosporin A (n = 12), TACimus (n = 12) or MMF only (n = 11); all with prednisone had a 12-h MPA-PK performed to ascertain the percentage of them within a defined therapeutic window. In 13 other patients, two PK studies undergone 1 wk apart were performed to evaluate the need for frequent measurements.
RESULTS: Fourteen (40%) patients were within the defined therapeutic window (36-60 microg h/mL). Nine patients (26%) were overexposed while 12 (34%) were underexposed. A Cmax> or =10 microg/mL was seen in 20 (57%) of the patients. These percentages were equally distributed between the treatment groups both for AUC0-12 and Cmax. The equations using C0, C2 or both predict exposure, although the use of C2 seems to be more adequate in clinical practice. There were no differences in MPA exposure in patients with a repeated PK evaluated 1 wk later.
CONCLUSION: The use of MMF without monitoring MPA blood levels may cause over-/underexposure to the drug in stable recipients. However, in patients under MMF for more than 1 yr, MPA levels are stable and there is no need for frequent measurements.
Authors:
Elias David-Neto; Lilian M Pereira; Erica Kakehashi; Nairo M Sumita; Maria E Mendes; Maria Cr Castro; Paschoalina Romano; Renata M Mattos; Vania Rm Batista; William C Nahas; Luiz E Ianhez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical transplantation     Volume:  19     ISSN:  0902-0063     ISO Abbreviation:  Clin Transplant     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-20     Completed Date:  2005-06-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  19-25     Citation Subset:  IM    
Affiliation:
Renal Transplant Unit, Divisions of Urology and Nephrology, Hospital das Clìnicas, University of São Paulo, School of Medicine, Sao Paulo, Brazil. elias.david.neto@attglobal.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Drug Monitoring*
Female
Humans
Immunosuppressive Agents / immunology,  therapeutic use*
Kidney Transplantation / immunology*
Male
Middle Aged
Mycophenolic Acid / analogs & derivatives*,  immunology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 24280-93-1/Mycophenolic Acid; 9242ECW6R0/mycophenolate mofetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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