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Long‐term dosing patterns of enteric‐coated mycophenolate sodium or mycophenolate mofetil with tacrolimus after renal transplantation
Author(s) -
Langone Anthony,
Shihab Fuad,
Pankewycz Oleh,
Doria Cataldo,
Wiland Anne,
McCague Kevin,
Chan Laurence
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12392
Subject(s) - medicine , mycophenolic acid , tacrolimus , dosing , urology , mycophenolate , renal function , transplantation , adverse effect , gastroenterology , kidney transplantation , urinary system , enteric coated
MORE was a four‐yr, prospective, observational study at 40 transplant centers in the US . Data were analyzed to evaluate changes in mycophenolic acid ( MPA ) dosing over time in 904 de novo kidney transplant recipients receiving enteric‐coated mycophenolate sodium ( EC ‐ MPS , n = 616) or mycophenolate mofetil ( MMF , n = 288) with tacrolimus. Induction therapy and steroid treatment were similar in the two subpopulations. The proportion of patients receiving the maximal recommended MPA dose was 80.5%, 43.9%, 39.2%, 34.6%, and 30.1% at baseline and years 1, 2, 3, and 4, respectively. More patients received the maximal recommended MPA dose with EC ‐ MPS vs. MMF at month 1 (79.2% vs. 71.7%, p = 0.016), month 3 (68.5% vs. 56.9%, p = 0.001), and month 6 (52.9% vs. 44.0%, p = 0.028). Multivariate analysis showed the risk of biopsy‐proven acute rejection, graft loss or death to be similar for EC ‐ MPS vs. MMF . Estimated glomerular filtration rate ( GFR ) was similar with EC ‐ MPS vs. MMF at all time points. There were no significant differences in any category of adverse event between the EC ‐ MPS and MMF cohorts during follow‐up, including gastrointestinal events. In conclusion, MPA dose was maintained more effectively in the first six months after kidney transplantation using EC ‐ MPS vs. MMF , without an increase in adverse events.