Clinical Evolution in the First 3 Months of Patients After Liver Transplantation in Maintenance Phase Converted From Mycophenolate Mofetil to Mycophenolate Sodium Due to Gastrointestinal Complications

Miras, M.; Carballo, Fernando; Egea, José Manuel Ortega; Martínez, Cecilia; Álvarez-López, María R.; Sánchez‐Bueno, Francisco; Parrilla, Pascual

doi:10.1016/j.transproceed.2007.06.038

Cited by 18 publications

(10 citation statements)

References 6 publications

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“…Converting patients receiving MMF to EC-MPS did not jeopardize efficacy with low rates of acute or chronic rejection or graft loss. Interestingly, in this study, the incidence of serious infections was significantly lower in the EC-MPS group (22). As reflected by the similar incidence of neutropenia, the hematologic safety profile is comparable between the two MPA derivatives.…”

supporting

confidence: 50%

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Myfortic in pediatric transplantation

Zimmerhackl

Jungraithmayr

Wiesmayr³

et al. 2008

Pediatric Transplantation

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supporting

confidence: 50%

“…The incidence/pattern of malignancies was low in both treatment groups and corresponded to the expected incidence in this patient population. Interestingly, in this study, the incidence of serious infections was significantly lower in the EC-MPS group (22).…”

mentioning

confidence: 40%

Myfortic in pediatric transplantation

Zimmerhackl

Jungraithmayr

Wiesmayr³

et al. 2008

Pediatric Transplantation

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“…Renal transplant studies have shown the use of EC-MPS to be as effective and as safe as MMF (37,38). However, studies on de novo use of EC-MPS in OLT recipients have been limited to conversion from MMF to EC-MPS (39)(40)(41). One study analyzed and showed that EC-MPS has similar efficacy to MMF as a primary immunosuppressant or as an MMF replacement in OLT recipients (42).…”

Section: Discussionmentioning

confidence: 99%

Completely steroid‐free immunosuppression in liver transplantation: a randomized study

Ramirez

Doria

Frank

et al. 2013

Clinical Transplantation

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Introduction Corticosteroids (CS) have been standard immunosuppression to prevent and treat rejection. However, CS are associated with increased risk of infection, obesity, hypertension, hyperlipidemia, diabetes, and accelerated hepatitis C virus (HCV) recurrence post‐orthotopic liver transplantation (OLT). This study assesses the safety and efficacy of CS‐free immunosuppressive regimen in adult OLT. Methods A two‐yr, prospective, randomized study of CS with delayed withdrawal (CS) or CS‐free regimen with basiliximab, tacrolimus, and enteric‐coated mycophenolate sodium (EC‐MPS) was performed in 39 patients (CS=20; CS‐free=19). CS group received intra‐operative methylprednisolone weaned by six months. HCV patients had HCV PCR pre‐OLT and 0.5, one, three, and six months post‐OLT. Protocol liver biopsies were performed at OLT, 2 and 24 wk post‐OLT or when indicated. Results Rejection occurred in two patients. Patient survival at one yr (100% vs. 95%), three yr (85% vs. 63%), and five yr (80% vs. 63%) post‐OLT were similar between CS and CS‐free group, respectively. Death‐censored graft survival at one yr (100% vs. 95%), three yr (85% vs. 63%), and five yr (75% vs. 63%) were also similar. The risk of new‐onset DM, hypertension, hypercholesterolemia, and weight gain was similar between groups. Conclusion CS avoidance with basiliximab, calcineurin inhibitor, and EC‐MPS is safe and effective as CS‐ containing immunosuppression in adult OLT.

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“…With appropriate dosing, EC‐MPS and MMF exhibit equivalent exposure to MPA, the active compound in both formulations (14). Clinical trials in both kidney and liver transplant recipients reveal that EC‐MPS is therapeutically equivalent to MMF, and that conversion may be completed safely and effectively (15–22).…”

mentioning

confidence: 99%

Improvement of gastrointestinal symptoms after conversion from mycophenolate mofetil to enteric‐coated mycophenolate sodium in liver transplant patients

Toledo

Hendrix

Buchholz

et al. 2011

Clinical Transplantation

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As many as 50% of liver transplant patients suffer gastrointestinal (GI) disturbances post-transplant. Conversion from mycophenolate mofetil (MMF) to mycophenolate sodium (EC-MPS) alleviates GI symptom burden in renal transplant recipients. We employed a validated patient and physician-reported assessment to evaluate the impact of conversion to EC-MPS in liver transplant patients. This is a prospective, longitudinal, single-center, open-label pilot study. Thirty-one MMF-treated liver transplant patients with GI symptoms were converted to equimolar EC-MPS. Gastrointestinal Symptom Rating Scale (GSRS), GI Quality of Life, SF-12v2 and physician-reported assessments were used to evaluate GI symptom burden and severity. A significant improvement in overall GSRS score was noted from baseline (2.57; 95% CI 2.12-3.10) to one month (1.90; 1.68-2.12; p = 0.0007) and three months (1.82; 1.60-2.04; p = 0.0002) post-conversion with significant reductions in all subgroups except Reflux. The overall Gastrointestinal Quality of Life Index (GIQLI) score also showed significant increase in health-related quality of life between one month (90.89; 84.04-97.75) and three months (100.04; 94.57-105.51; p = 0.0009), with all subgroups except social functioning (p = 0.0861) and medical treatment (p = 0.3156) demonstrating significant improvements. This pilot study demonstrates improvement in GI symptom burden when converting from equimolar doses of MMF to EC-MPS. This benefit persisted for three months without evidence of rejection.

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Clinical Evolution in the First 3 Months of Patients After Liver Transplantation in Maintenance Phase Converted From Mycophenolate Mofetil to Mycophenolate Sodium Due to Gastrointestinal Complications

Cited by 18 publications

References 6 publications

Myfortic in pediatric transplantation

Myfortic in pediatric transplantation

Completely steroid‐free immunosuppression in liver transplantation: a randomized study

Improvement of gastrointestinal symptoms after conversion from mycophenolate mofetil to enteric‐coated mycophenolate sodium in liver transplant patients

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