Kidney transplantationOutcomeRenal Transplant Patients With Gastrointestinal Intolerability to Mycophenolate Mofetil: Conversion to Enteric-Coated Mycophenolate Sodium
Section snippets
Materials and methods
We performed a prospective study of 39 stable kidney transplant patients (median time posttransplantation = 44 months) who were receiving MMF and maintenance immunosuppressive therapy (24 patients with tacrolimus, 10 with cyclosporine, and five with sirolimus). These patients displayed GI intolerance to MMF and were therefore converted to equipotent doses of EC-MPS.
Results
Table 1 shows the most important results. The median preconversion dose of MMF was 750 mg (range = 0 to 1000 mg) and the median postconversion dose of EC-MPS was 720 mg (range = 180 to 1080 mg). The serum creatinine fell after 3 months from 1.83 ± 0.12 mg/dL to 1.70 ± 0.10 mg/dL (P < .03). At 3 months levels of mycophenolic acid had increased from 1.46 μg/mL to 2.56 μg/mL (P < .01) and those of calcineurin inhibitors were decreased: Tacrolimus levels preconversion were 10.8 ± 0.8 ng/mL and at 3
Discussion
The new formulation for delivering mycophenolic acid, EC-MPS, was developed with the aim of improving mycophenolic acid–related GI AEs. The present study showed a significant improvement in GI AEs after conversion from MMF to EC-MPS. There was also an increase in mycophenolic acid serum levels. This might be explained because of better GI absorption with EC-MPS. This more suitable immunosuppression therapy permits use of lower doses of calcineurin inhibitors, with both factors contributing to
References (6)
Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients
Transplantation
(1995)A blinded, randomized, clinical trial of mycophenolate mofetil for the prevention of acute rejection in cadaveric renal transplantation
Transplantation
(1996)- et al.
Mycophenolate mofetil reduces late renal allograft loss independent of acute rejection
Transplantation
(2000)