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Short‐term therapeutic drug monitoring of mycophenolic acid reduces infection: a prospective, single‐center cohort study in Chinese living‐related kidney transplantation
Author(s) -
Fu L.,
Huang Z.,
Song T.,
He S.,
Zeng D.,
Rao Z.,
Xie L.,
Song Y.,
Wang L.,
Lin T.
Publication year - 2014
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12275
Subject(s) - medicine , mycophenolic acid , discontinuation , therapeutic drug monitoring , gastroenterology , transplantation , kidney transplantation , prospective cohort study , mycophenolate , single center , clinical endpoint , cohort , population , surgery , urology , randomized controlled trial , pharmacokinetics , environmental health
Background The role of therapeutic drug monitoring ( TDM ) of mycophenolic acid ( MPA ) in kidney transplant recipients ( KTR s) is not clear. We performed a prospective cohort study to evaluate the efficiency of MPA TDM in the C hinese population. Methods A total of 183 living‐related KTR s were studied; 101 KTR s received controlled‐dose mycophenolate mofetil ( MMF ) (the CD group), and 82 patients received fixed‐dose MMF (the FD group). MPA exposure was measured at days 3, 7, 14, and 30 in the CD group, and at day 30 in the FD group. The primary endpoint was treatment failure (a composite of acute rejection, graft loss, death, or MMF discontinuation) at 12 months post transplantation. Results In the CD group, with a starting MMF dose of 2 g/day, approximately 35% of patients had high MPA levels, which were >60 mg × h/L, and mean MPA levels were 59.17 mg × h/L and 61.38 mg × h/L for the CD and FD groups, respectively ( P = 0.588). After adjusting MMF dose, MPA exposures in the CD group at day 30 were lower than those in the FD group at day 30 (54.06 vs. 61.38, P = 0.004). At month 12, the CD group had fewer infections (16.8% vs. 31.7%, P = 0.018) with no difference in treatment failure, acute rejection, diarrhea, or anemia. Conclusions KTR s can benefit from short‐term TDM of MPA in reducing infection, without increasing acute rejection.