Short‐term therapeutic drug monitoring of mycophenolic acid reduces infection: a prospective, single‐center cohort study in Chinese living‐related kidney transplantation. Issue 5 (5th August 2014)

• Record Type: Journal Article
• Authors: Fu, L.; Huang, Z.; Song, T.; He, S.; Zeng, D.; Rao, Z.; Xie, L.; Song, Y.; Wang, L.; Lin, T.
• Is Part Of: Transplant infectious disease. Volume 16:Issue 5(2014)
• Page Start: 760
• Page End: 766
• Publication Date: 2014-08-05
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12275
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12275-abs-0001"> <title>Abstract</title> <sec id="tid12275-sec-0001" sec-type="section"> <title>Background</title> <p>The role of therapeutic drug monitoring (TDM) of mycophenolic acid (MPA) in kidney transplant recipients (KTRs) is not clear. We performed a prospective cohort study to evaluate the efficiency of MPA TDM in the Chinese population.</p> </sec> <sec id="tid12275-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 183 living‐related KTRs were studied; 101 KTRs received controlled‐dose mycophenolate mofetil (MMF) (the CD group), and 82 patients received fixed‐dose MMF (the FD group). MPA exposure was measured at days 3, 7, 14, and 30 in the CD group, and at day 30 in the FD group. The primary endpoint was treatment failure (a composite of acute rejection, graft loss, death, or MMF discontinuation) at 12 months post transplantation.</p> </sec> <sec id="tid12275-sec-0003" sec-type="section"> <title>Results</title> <p>In the CD group, with a starting MMF dose of 2 g/day, approximately 35% of patients had high MPA levels, which were >60 mg × h/L, and mean MPA levels were 59.17 mg × h/L and 61.38 mg × h/L for the CD and FD groups, respectively (<italic>P</italic> = 0.588). After adjusting MMF dose, MPA exposures in the CD group at day 30 were lower than those in the FD group at day 30 (54.06 vs. 61.38, <italic>P</italic> = 0.004). At month 12, the CD group had fewer infections (16.8% vs. 31.7%, <italic>P</italic> = 0.018) with no difference in treatment failure, acute rejection, diarrhea, or anemia.</p> </sec> <sec id="tid12275-sec-0004" sec-type="section"> <title>Conclusions</title> <p>KTRs can benefit from short‐term TDM of MPA in reducing infection, without increasing acute rejection.</p> </sec> </abstract>