Personalized Therapy for Mycophenolate: Consensus Report by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology

Autor: Mercè Brunet, Eberhard Wieland, Alexander A. Vinks, Pierre Wallemacq, Nils Tore Vethe, Nicolas Picard, Dirk Jan A.R. Moes, Mariadelfina Molinaro, Paweł K. Kunicki, Klemens Budde, Satohiro Masuda, Maja Theresa Dieterlen, Tomoyuki Mizuno, Stein Bergan, Laure Elens, Anders Åsberg, Olga Millán, Florian Lemaitre, Burkhard Tönshoff, Maria Shipkova, Jesse J. Swen, Teun van Gelder, Tomasz Pawinski, Vincent Haufroid, Ofelia Noceti, Tom C. Zwart, Pierre Marquet, Smita Pattanaik, Jean-Baptiste Woillard, Loralie J. Langman, Markus J. Barten, Dennis A. Hesselink, Ron H.N. van Schaik, Michael Oellerich, Christoph Seger, Linda Salzmann, Kamisha L. Johnson-Davis, Raman Venkataramanan
Přispěvatelé: UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - SSS/IREC/LTAP - Louvain Centre for Toxicology and Applied Pharmacology, University of Oslo (UiO), University of Barcelona, Erasmus University Medical Center [Rotterdam] (Erasmus MC), University of Utah, Medical University of Warsaw - Poland, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Ciblage individuel et prévention des risques de traitements immunosupresseurs et de la transplantation (IPPRITT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Fondazione IRCCS Policlinico San Matteo [Pavia], Università di Pavia, Leiden University Medical Center (LUMC), University of Pittsburgh School of Medicine, Pennsylvania Commonwealth System of Higher Education (PCSHE), University Heart Center [Hamburg], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University Hospital Leipzig, Louvain Drug Research Institute [Bruxelles, Belgique] (LDRI), Université Catholique de Louvain = Catholic University of Louvain (UCL), Cliniques Universitaires Saint-Luc [Bruxelles], International University of Health and Welfare (IUHW), University of Cincinnati (UC), University Medical Center Göttingen (UMG), Heidelberg University Hospital [Heidelberg], Cliniques universitaires St Luc [Bruxelles], Mayo Clinic [Jacksonville], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Università degli Studi di Pavia = University of Pavia (UNIPV), Universiteit Leiden, Chard-Hutchinson, Xavier
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Therapeutic Drug Monitoring, Vol. 43, no.2, p. 150-200 (2021)
Therapeutic Drug Monitoring
Therapeutic Drug Monitoring, Lippincott, Williams & Wilkins, 2021, 43 (2), pp.150-200. ⟨10.1097/FTD.0000000000000871⟩
Therapeutic Drug Monitoring, 2021, 43 (2), pp.150-200. ⟨10.1097/FTD.0000000000000871⟩
Therapeutic Drug Monitoring, 43(2), 150-200. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 0163-4356
Popis: When mycophenolic acid (MPA) was originally marketed for immunosuppressive therapy, fixed doses were recommended by the manufacturer. Awareness of the potential for a more personalized dosing has led to development of methods to estimate MPA area under the curve based on the measurement of drug concentrations in only a few samples. This approach is feasible in the clinical routine and has proven successful in terms of correlation with outcome. However, the search for superior correlates has continued, and numerous studies in search of biomarkers that could better predict the perfect dosage for the individual patient have been published. As it was considered timely for an updated and comprehensive presentation of consensus on the status for personalized treatment with MPA, this report was prepared following an initiative from members of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT). Topics included are the criteria for analytics, methods to estimate exposure including pharmacometrics, the potential influence of pharmacogenetics, development of biomarkers, and the practical aspects of implementation of target concentration intervention. For selected topics with sufficient evidence, such as the application of limited sampling strategies for MPA area under the curve, graded recommendations on target ranges are presented. To provide a comprehensive review, this report also includes updates on the status of potential biomarkers including those which may be promising but with a low level of evidence. In view of the fact that there are very few new immunosuppressive drugs under development for the transplant field, it is likely that MPA will continue to be prescribed on a large scale in the upcoming years. Discontinuation of therapy due to adverse effects is relatively common, increasing the risk for late rejections, which may contribute to graft loss. Therefore, the continued search for innovative methods to better personalize MPA dosage is warranted. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved
Databáze: OpenAIRE
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