Abstract |
This study examines the importance of early mycophenolic acid (MPA) exposure in the cyclosporine- and mycophenolate mofetil (MMF)-treated kidney transplant population. We prospectively evaluated 94 first solitary kidney transplant patients treated with cyclosporine ( Neoral), MMF, and prednisone. Basiliximab was also given to 72 recipients. MPA exposure was measured by HPLC using a limited sampling estimate of 12 h area under the curve (AUC [0-12]) within the first week. Efficacy was determined by the occurrence of acute rejection and toxicity by the need to reduce MMF doses within the first 3 months post- transplantation. Acute rejection was observed in 14 (15%) and MMF toxicity in 27 (29%). Receiver operator curve analysis shows that MPA AUC [0-12] on day 3 was predictive of efficacy (c = 0.72, p = 0.007) but not toxicity (c = 0.57, p = 0.285). A separate analysis of only patients on basiliximab shows that the MPA AUC [0-12] on day 3 was also predictive of efficacy (c = 0.80, p = 0.01). Therefore early adequate exposure to MPA by day 3 is associated with low acute rejection but cannot predict toxicity. Adequate MPA exposure is also important with basiliximab induction therapy.
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Authors | Bryce A Kiberd, Joseph Lawen, Albert D Fraser, Tammy Keough-Ryan, Philip Belitsky |
Journal | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
(Am J Transplant)
Vol. 4
Issue 7
Pg. 1079-83
(Jul 2004)
ISSN: 1600-6135 [Print] United States |
PMID | 15196064
(Publication Type: Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Immunosuppressive Agents
- Recombinant Fusion Proteins
- Cyclosporine
- Basiliximab
- Mycophenolic Acid
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Topics |
- Adult
- Aged
- Antibodies, Monoclonal
(pharmacology)
- Basiliximab
- Chromatography, High Pressure Liquid
- Cyclosporine
(pharmacology)
- Female
- Graft Rejection
- Graft Survival
- Humans
- Immunosuppressive Agents
(pharmacology)
- Kidney Transplantation
(methods)
- Male
- Middle Aged
- Mycophenolic Acid
(analogs & derivatives, metabolism, pharmacology)
- Proportional Hazards Models
- Prospective Studies
- ROC Curve
- Recombinant Fusion Proteins
(pharmacology)
- Sensitivity and Specificity
- Time Factors
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