Cyclosporine A and tacrolimus combined with enteric‐coated mycophenolate sodium influence the plasma mycophenolic acid concentration – a randomised controlled trial in Chinese live related donor kidney transplant recipients. (April 2014)

• Record Type: Journal Article
• Authors: Huang, H. F.; Yao, X.; Chen, Y.; Xie, W. Q.; Shen‐Tu, J. Z.; Chen, J. H.
• Is Part Of: International journal of clinical practice. Volume 68(2014)Supplement 181
• Page Start: 4
• Page End: 9
• Publication Date: 2014-04
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12400
• Languages: English
• ISSNs: 1368-5031

Abstract

Summary: Objective: To observe the different concentrations of mycophenolic acid (MPA) during the early post‐transplant phase for various combinations of cyclosporine A (CsA) and tacrolimus (Tac) with enteric‐coated mycophenolate sodium (EC‐MPS). Method: A total of 42 Chinese adults receiving live related donor kidney transplants were studied. All received a triple immunosuppressive regimen of EC‐MPS, CsA/Tac and corticosteroids and were divided randomly into CsA ( n = 21) and Tac ( n = 21) combination groups. The dosage of EC‐MPS was the same (1440 mg/day) in the two groups. The MPA concentration was evaluated with an enzyme‐multiplied immunoassay technique (EMIT) and the pharmacokinetic characteristics were investigated in both groups. Results: The mean maximum plasma concentrations ( C max ) of MPA in the CsA and Tac groups were 11.365 ± 9.522 and 9.748 ± 7.523 μg/ml, respectively (p = 0.137). The maximum times to C max ( T max ) were 2.54 ± 1.53 and 2.67 ± 1.08 h, respectively (p = 0.341). The mean MPA 12‐h areas under the curve (MPA‐AUC0–12 h ) were 59.463 ± 16.252 and 77.535 ± 33.615 μg h/ml (p = 0.003) and the mean residence times (MRT) were 3.71 ± 0.829 and 3.928 ± 0.923 h (p = 0.038). Conclusion: Combined with the same EC‐MPS dosage (1440 mg/day), the MPA‐AUC0–12 of the Tac group was higher than that of the CsA group, and the Tac group had a longer MRT after kidney transplantation. Our data indicate that the concentration of MPA should be monitored in clinical therapy when EC‐MPS is combined with different calcineurin inhibitors to reduce acute allograft rejection and avoid adverse events.