Mycophenolic acid formulations in adult renal transplantation - update on efficacy and tolerability.

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Version: author
Serval ID
serval:BIB_267B22276362
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Mycophenolic acid formulations in adult renal transplantation - update on efficacy and tolerability.
Journal
Therapeutics and Clinical Risk Management
Author(s)
Golshayan D., Pascual M., Vogt B.
ISSN
1176-6336
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
5
Number
4
Pages
341-351
Language
english
Abstract
The description more than 30 years ago of the role of de novo purine synthesis in T and B lymphocytes clonal proliferation opened the possibility for selective immunosuppression by targeting specific enzymatic pathways. Mycophenolic acid (MPA) blocks the key enzyme inosine monophosphate dehydrogenase and the production of guanosine nucleotides required for DNA synthesis. Two MPA formulations are currently used in clinical transplantation as part of the maintenance immunosuppressive regimen. Mycophenolate mofetil (MMF) was the first MPA agent to be approved for the prevention of acute rejection following renal transplantation, in combination with cyclosporine and steroids. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative MPA formulation available in clinical transplantation. In this review, we will discuss the clinical trials that have evaluated the efficacy and safety of MPA in adult kidney transplantation for the prevention of acute rejection and their use in new combination regimens aiming at minimizing calcineurin inhibitor toxicity and chronic allograft nephropathy. We will also discuss MPA pharmacokinetics and the rationale for therapeutic drug monitoring in optimizing the balance between efficacy and safety in individual patients.
Pubmed
Create date
03/07/2009 13:24
Last modification date
20/08/2019 13:05
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