Mycophenolate monitoring in liver, thoracic, pancreas, and small bowel transplantation: a consensus report
| Autor: | Teun van Gelder, Mary H H Ensom, Dirk Kuypers, Marcelo Cantarovich, Nigel W. Brown, J. Michael Tredger, Ashok Jain |
|---|---|
| Přispěvatelé: | Pharmacy |
| Rok vydání: | 2011 |
| Předmět: |
Graft Rejection
Transplantation medicine.medical_specialty business.industry medicine.medical_treatment Urology Mycophenolic Acid Pancreas transplantation Liver transplantation Mycophenolate Mycophenolic acid Liver Transplantation Surgery Clinical trial Regimen Intestine Small medicine Humans Pancreas Transplantation Drug Monitoring business Adverse effect Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation Reviews, 25, 65-77. W.B. Saunders |
| ISSN: | 0955-470X |
| DOI: | 10.1016/j.trre.2010.12.001 |
| Popis: | Assessing the value of mycophenolic acid (MPA) monitoring outside renal transplantation is hindered by the absence of any trial comparing fixed-dose and concentration-controlled therapy. However, in liver and thoracic transplantation particularly, clinical trials, observational studies with comparison groups, and case series have described MPA efficacy, exposure/efficacy relationships, pharmacokinetic variability, and clinical outcomes relating to plasma MPA concentrations. On the basis of this evidence, this report identifies MPA as an immunosuppressant for which the combination of variable disposition, efficacy, and adverse effects contributes to interindividual differences seemingly in excess of those optimal for a fixed-dosage mycophenolate regimen. Combined with experiences of MPA monitoring in other transplant indications, the data have been rationalized to define circumstances in which measurement of MPA concentrations can contribute to improved management of mycophenolate therapy in nonrenal transplant recipients. |
| Databáze: | OpenAIRE |
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