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Comparison of Azathioprine and Mycophenolate Mofetil for the Prevention of Acute Rejection in Recipients of Pancreas Transplantation
Author(s) -
Oh Jung M.,
Wiland Anne M.,
Klassen David K.,
Weidle Paul J.,
Bartlett Stephen T.
Publication year - 2001
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/00912700122010762
Subject(s) - medicine , azathioprine , pancreas transplantation , transplantation , adverse effect , tacrolimus , gastroenterology , pancreas , mycophenolate , immunosuppression , biopsy , surgery , mycophenolic acid , kidney transplantation , disease
The study was performed to compare the efficacy and side effects of azathioprine (AZA) and mycophenolate mofetil (MMF) in conjunction with cyclosporine or tacrolimus and steroids for the prevention of acute pancreas rejection during the first 6 months of pancreas transplantation. In this case‐controlled study, MMF is compared with historical controls of AZA in the prevention of acute pancreas rejection. The primary measures of treatment efficacy were patient and pancreas survival rate at 6 months after transplantation. Secondary efficacy measures were the occurrence of biopsyproven pancreas rejections and the use of antilymphocyte preparations for rejection treatment. A total of 111 pancreas transplant patients (57 in the AZA group and 54 in the MMF group) were evaluated. The 6‐month patient survival rate was 96% in the AZA group versus 97% in the MMF group (p = 0.57). The 6‐month pancreas graft survival rate was 88% in the AZA group versus 91% in the MMF group (p = 0.29). However, biopsy‐proven rejection episodes during the first 6 months of transplantation were significantly lower with MMF (46%) than with AZA (69%) (p = 0.01). In addition, patients in the AZA group received a greater number of full courses of antilymphocyte therapy as a rejection treatment (p = 0.004). Overall, the frequency of adverse events was similar, although the MMF group experienced higher incidences of gastrointestinal adverse events. In conclusion, compared with AZA, MMF significantly reduces the rate of biopsy‐proven pancreas rejection during the first 6 months of transplantation and is well tolerated, except for gastrointestinal adverse events .