From Therapeutic Drug Monitoring To Drug Management

Authors

 Manfred Küpper1), 2) AND Rana Hallak3)

Abstract

Mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (ECMPS) are well established in immunosuppressive therapy after renal transplantation. The active substance, mycophenolic acid, leads to an inhibition of inosine-monophosphate-dehydrogenase (IMPDH) activity in peripheral mononuclear cells. Adverse side effects, most prominently gastrointestinal (GIT) side effects, lead to dose reduction in more than half of the patients, increasing the risk for acute rejection. Therapeutic drug monitoring (TDM) by measuring the trough level shows no relevant correlations with MPA-AUC values, and is consequently obsolete for assessing the risk of graft loss. Therefore the residual IMPDH activity in stable maintenance renal transplant patients was determined in order to suggest trusted intervals allowing monitoring of the level of immunosuppression in the context of dose-reduction. In order to compare the efficacy of the two galenisms, MMF and EC-MPS, respectively, the effect of different dosing patterns of MMF and EC-MPS on IMPDH activity in stable patients after renal transplantation was analyzed.

الملفات المرفقة

Syrian Private University - Pharmacy @ 2024 by Syrian Monster - Web Service Provider | All Rights Reserved