Mycophenolic acid drug monitoring in patients with systemic sclerosis associated with diffuse skin and/or pulmonary involvement: A monocentric and retrospective French study
| Autor: | Raphaël Porcher, Benjamin Terrier, Jonathan London, Luc Mouthon, Paul Legendre, Alice Bérezné, Marie Allard, Claire Le Jeunne, Benoit Blanchet, Pascal Cohen |
|---|---|
| Přispěvatelé: | Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Synthèse et structure de molécules d'interet pharmacologique (SSMIP), Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Hôpital Cochin [AP-HP], Hôpital Hôtel-Dieu [Paris], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Porcher, Raphaël |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Drug
medicine.medical_specialty diffuse PK/PD relationship media_common.quotation_subject Immunology Original Manuscript 030226 pharmacology & pharmacy Gastroenterology Mycophenolic acid 03 medical and health sciences 0302 clinical medicine Rheumatology Pharmacokinetics Internal medicine medicine Immunology and Allergy In patient media_common 030203 arthritis & rheumatology interstitial lung disease [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology integumentary system business.industry Interstitial lung disease Area under the curve mycophenolate mofetil medicine.disease Pharmacodynamics Systemic sclerosis business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug |
| Zdroj: | Journal of Scleroderma and Related Disorders Journal of Scleroderma and Related Disorders, 2021, 6 (1), pp.87-95. ⟨10.1177/2397198320944342⟩ J Scleroderma Relat Disord |
| ISSN: | 2397-1983 2397-1991 |
| DOI: | 10.1177/2397198320944342⟩ |
| Popis: | Objective: To explore pharmacokinetic/pharmacodynamic relationship between mycophenolic acid area under the curve and clinical response at 1 year on skin involvement or interstitial lung disease in patients with systemic sclerosis. Method: Retrospective, monocentric study based on French Scleroderma Database in patients receiving mycophenolate mofetil who experienced a limited sampling strategy to estimate individual mycophenolic acid area under the curve plus two pulmonary function tests and skin evaluation after 1 month and 1 year. Efficacy criterions were variations of modified Rodnan skin score, forced vital capacity, and diffusing lung capacity for carbon monoxide at 1 year. Results: We included 52 patients; mean age was 49 years (range 17–79), and 36 (69%) were females. Fifty patients (96%) had skin sclerosis, 39 (75%) had diffuse skin involvement with a median modified Rodnan skin score of 14 (0–38). Thirty-eight (76%) had interstitial lung disease, with median forced vital capacity and diffusing lung capacity for carbon monoxide of 81% (37–127) and 56% (28–103) from predicted values, respectively. Twenty-five (51%) patients had pulmonary fibrosis. Mycophenolate mofetil was given for 10 months (0–173) at a median dose of 2000 mg/day (500–3000). In the entire population, no relationship was found between area under the curve and modified Rodnan skin score (p = 0.085), forced vital capacity (p = 0.80), or diffusing lung capacity for carbon monoxide (p = 0.72) variations at 1 year. Conclusion: In this retrospective study, we failed to document any relationship between mycophenolic acid area under the curve and skin involvement or interstitial lung disease evolution. Routine monitoring of mycophenolic acid in systemic sclerosis patients treated with mycophenolate mofetil cannot be recommended based on our results. |
| Databáze: | OpenAIRE |
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