Mycophenolic acid pharmacodynamics and pharmacokinetics provide a basis for rational monitoring strategies
Leslie M. Shaw,Magdalena Korecka,Raman Venkataramanan,Lee R. Goldberg,Roy D. Bloom,Kenneth L. Brayman +5 more
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TLDR
There is strong evidence that maintenance CIN-MMFsteroid-based triple therapy, initiated in the early posttransplant period significantly reduces the risk of acute rejection in the first post-transplant year, when compared to double therapy regimens comprising CIN and steroids alone.About:
This article is published in American Journal of Transplantation.The article was published on 2003-05-01 and is currently open access. It has received 232 citations till now. The article focuses on the topics: Mycophenolic acid & Sirolimus.read more
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Journal ArticleDOI
Clinical Pharmacokinetics and Pharmacodynamics of Mycophenolate in Solid Organ Transplant Recipients
TL;DR: This review aims to provide an extensive overview of the literature on the clinical pharmacokinetics of mycophenolate in solid organ transplantation and a briefer summary of current pharmacodynamic information.
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Individualized mycophenolate mofetil dosing based on drug exposure significantly improves patient outcomes after renal transplantation.
Y. Le Meur,Mathias Büchler,Antoine Thierry,Sophie Caillard,Florence Villemain,Sylvie Lavaud,Isabelle Etienne,Pierre-François Westeel,B. H. de Ligny,Lionel Rostaing,Eric Thervet,Jean-Christophe Szelag,Jean-Philippe Rerolle,Alexandra Rousseau,Guy Touchard,Pierre Marquet +15 more
TL;DR: Therapeutic MPA monitoring using a limited sampling strategy can reduce the risk of treatment failure and acute rejection in renal allograft recipients 12 months posttransplant with no increase in adverse events.
Journal ArticleDOI
Therapeutic drug monitoring of mycophenolate mofetil in transplantation.
Teun van Gelder,Yann Le Meur,Leslie M. Shaw,Michael Oellerich,David DeNofrio,Curtis Holt,David W. Holt,Bruce Kaplan,Dirk Kuypers,Bruno Meiser,Burkhard Toenshoff,Richard D. Mamelok +11 more
TL;DR: A roundtable meeting to discuss the use of therapeutic drug monitoring (TDM) to guide immunosuppression with mycophenolate mofetil was held in New York in December 2004, and it was agreed that TDM might help optimize outcomes, especially in patients at higher risk of rejection.
Journal ArticleDOI
Cyclosporine interacts with mycophenolic acid by inhibiting the multidrug resistance-associated protein 2.
Dennis A. Hesselink,Reinier M. van Hest,Ron A. A. Mathôt,Fred Bonthuis,Willem Weimar,Ron W. F. de Bruin,Teun van Gelder +6 more
TL;DR: It is concluded that the pharmacokinetics of MMF are comparable in Mrp2‐deficient rats receiving either CsA or Tac as co‐medication, and this finding suggests thatCsA‐mediated inhibition of the biliary excretion of MPAG by theMrp2 transporter is the mechanism responsible for the interaction between Cs a and MMF.
Journal ArticleDOI
Consensus report on therapeutic drug monitoring of mycophenolic acid in solid organ transplantation.
Dirk Kuypers,Yannick Le Meur,Marcelo Cantarovich,Michael J. Tredger,Susan E. Tett,Dario Cattaneo,Burkhard Tönshoff,David W. Holt,Jeremy R. Chapman,Teun van Gelder +9 more
TL;DR: The goal of this consensus meeting was to offer information to transplant practitioners on clinically relevant pharmacokinetic characteristics of MPA, to rationalize the basis for currently advised target exposure ranges for MPA in various types of organ transplantation, and to summarize available methods for application of M PA TDM in clinical practice.
References
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Journal ArticleDOI
Clinical Pharmacokinetics of Mycophenolate Mofetil
TL;DR: The pharmacokinetics of patients with renal transplants compared with those of healthy individuals were similar after oral mycophenolate mofetil, but there was a progressive decrease in MPAG clearance as glomerular filtration rate (GFR) declined.
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A randomized double-blind, multicenter plasma concentration controlled study of the safety and efficacy of oral mycophenolate mofetil for the prevention of acute rejection after kidney transplantation.
T. van Gelder,L.B. Hilbrands,Yves Vanrenterghem,W. Weimar,J.W. de Fijter,Jean-Paul Squifflet,R. J. Hene,Gert A. Verpooten,M T Navarro,M. D. Hale,Andrew J. Nicholls +10 more
TL;DR: MPA C predose and MPA AUC are significantly related to the incidence of biopsy-proven rejection after kidney transplantation, whereas MMF dose is significantly relatedto the occurrence of adverse events.
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The pharmacokinetic‐pharmacodynamic relationship for mycophenolate mofetil in renal transplantation
M. D. Hale,Andrew J. Nicholls,Roy Bullingham,Ronald Hené,Andries J. Hoitsma,Jean-Paul Squifflet,Willem Weimar,Yves Vanrenterghem,Fokko J. Van de Woude,Gert A. Verpooten +9 more
TL;DR: Mycophenolate mofetil, a pro‐drug for mycophenolic acid, reduces the likelihood of allograft rejection after renal transplantation and is studied in a randomized concentration‐controlled trial.
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Structure and Mechanism of Inosine Monophosphate Dehydrogenase in Complex with the Immunosuppressant Mycophenolic Acid
Michael D. Sintchak,Mark A. Fleming,Olga Futer,Scott A. Raybuck,Stephen P. Chambers,Paul R. Caron,Murcko Mark A,Wilson Keith P +7 more
TL;DR: The structure of inosine-5'-monophosphate dehydrogenase in complex with IMP and mycophenolic acid (MPA) has been determined by X-ray diffraction and indicates that MPA inhibits IMPDH by acting as a replacement for the Nicotinamide portion of the nicotinamide adenine dinucleotide cofactor and a catalytic water molecule.
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The role of hepatic and extrahepatic udp-glucuronosyltransferases in human drug metabolism *,†
TL;DR: A significant expression of UGT1A1 in human small intestine, an enzyme possessing considerable allelic variability and a polymorphic expression pattern in intestine are identified, which plays a major role not only in first pass metabolism, but also in the degree of interindividual variation in overall oral bioavailability.