Cyclosporine A and tacrolimus combined with enteric-coated mycophenolate sodium influence the plasma mycophenolic acid concentration - a randomised controlled trial in Chinese live related donor kidney transplant recipients

Huang, Hongfeng; Yao, Xin; Chen, Y.; Xie, Wenqing; Shentu, Jianzhong; Chen, J. H.

doi:10.1111/ijcp.12400

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…MPA concentration-time profile generally has two peak concentrations: maximum within 1-2 h postadministration and 6-12 h post-administration due to resorption from EHC in healthy subjects and solid organ transplant patients. [28][29][30][31] When patients were administered MMF in combination with cyclosporine, which is derived from hepatic MRP2 inhibition, 2 MPA exposure is approximately 30-40% lower than when given alone or with tacrolimus. 1 Contrarily, all patients were administered tacrolimus with MMF and not dosed any MRP2 inhibitor in this study.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Uchiyama

Saito

Takekuma

et al. 2020

J Oncol Pharm Pract

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Purpose Mycophenolate mofetil (MMF), a mycophenolic acid (MPA) prodrug, is used to prevent graft-versus-host disease (GVHD) in hematopoietic stem cell transplantation (HSCT). Although previous studies have reported that enterohepatic circulation (EHC) of MPA, which is usually observed in MMF-treated patients, does not occur in HSCT patients, it is unclear what happens in haploidentical–HSCT (haplo-HSCT) patients, who are using post-transplant cyclophosphamide. This study was conducted to investigate MPA pharmacokinetics in haplo-HSCT patients. Methods Seventeen haplo-HSCT patients, who received MMF for GVHD prophylaxis, were enrolled in this study. We collected blood samples on days 14 and 28, and plasma MPA concentrations were measured by high-performance liquid chromatography; pharmacokinetic parameters such as area under the curve (AUC), mean residence time (MRT), and apparent oral clearance (CL/F) were measured with moment analysis. We also evaluated EHC as AUC6-12h/AUC0-12h. Results There was no significant difference in MPA pharmacokinetic parameters between days 14 and 28. There was also no difference between the pharmacokinetic parameter changes and diarrhea. Additionally, varying plasma MPA concentrations suggested that MPA EHC did not occur. Conclusion In this study, we revealed the pharmacokinetics of MMF in Japanese haplo-HSCT recipients. Additionally, our study demonstrated that MPA EHC might not occur in Japanese haplo-HSCT recipients.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Uchiyama

Saito

Takekuma

et al. 2020

J Oncol Pharm Pract

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“…Therefore, the MPA concentration should also be monitored when combined with calcineurin inhibitors, in order to improve the safety of transplant recipients. 70 …”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Tacrolimus in preventing transplant rejection in Chinese patients – optimizing use

Li¹,

Li²

2015

DDDT

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Tacrolimus is a product of fermentation of Streptomyces, and belongs to the family of calcineurin inhibitors. It is a widely used immunosuppressive drug for preventing solid-organ transplant rejection. Compared to cyclosporine, tacrolimus has greater immunosuppressive potency and a lower incidence of side effects. It has been accepted as first-line treatment after liver and kidney transplantation. Tacrolimus has specific features in Chinese transplant patients; its in vivo pharmacokinetics, treatment regimen, dose and administration, and adverse-effect profile are influenced by multiple factors, such as genetics and the spectrum of primary diseases in the Chinese population. We reviewed the clinical experience of tacrolimus use in Chinese liver- and kidney-transplant patients, including the pharmacology of tacrolimus, the immunosuppressive effects of tacrolimus versus cyclosporine, effects of different factors on tacrolimus metabolism on Chinese patients, personalized medicine, clinical safety profile, and patient satisfaction and adherence. This article provides guidance for the rational and efficient use of tacrolimus in Chinese organ-transplant patients.

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“…Approximately 90% of patients are able to cope with infection, and they do not have any symptoms, but in 5-10 % of cases, it leads to death (7-10). There are studies on outcomes and side effects of immunosuppressive therapy in kidney and liver transplant patients with new combinations of immunosuppressant therapies (11)(12)(13)(14)(15)(16) We retrospectively analyzed records of 228 patients who underwent organ (kidney -178 and liver -50) transplantation between 1999 and 2017, received immunosuppression therapy and have been followed up in our clinic.…”

mentioning

confidence: 99%

Types and Structure of Complications, and Causes of Mortality with Different Combinations of Immunosuppressants in Patients of Undergoing Organ Transplantation

Ashimov¹,

Gaibyldaev²

2017

HVT

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We aimed to retrospectively analyze morbidity and mortality in recipients of kidney and liver transplant receiving immunosuppressive therapy (tacrolimus and cyclosporine with mycophenolate mofetil and mycophenolic acid). Overall, 228 patients who underwent kidney and liver transplantation were included in the study. The overall graft survival of patients who underwent kidney and liver transplantation from 1999 to 2017 was 84.2%. Combinations including cyclosporine, were associated with high rate of complications acute rejection, CMV and candida infections as compared to tacrolimus. The most unfavorable in terms of mortality was combination of cyclosporine -mycophenolate mofetil.

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Cyclosporine A and tacrolimus combined with enteric-coated mycophenolate sodium influence the plasma mycophenolic acid concentration - a randomised controlled trial in Chinese live related donor kidney transplant recipients

Cited by 4 publications

References 27 publications

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Tacrolimus in preventing transplant rejection in Chinese patients – optimizing use

Types and Structure of Complications, and Causes of Mortality with Different Combinations of Immunosuppressants in Patients of Undergoing Organ Transplantation

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Cyclosporine A and tacrolimus combined with enteric-coated mycophenolate sodium influence the plasma mycophenolic acid concentration - a randomised controlled trial in Chinese live related donor kidney transplant recipients

Cited by 4 publications

References 27 publications

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Pharmacokinetics of mycophenolic acid after haplo-hematopoietic stem cell transplantation in Japanese recipients

Tacrolimus in preventing transplant rejection in&nbsp;Chinese patients &ndash; optimizing use

Types and Structure of Complications, and Causes of Mortality with Different Combinations of Immunosuppressants in Patients of Undergoing Organ Transplantation

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Tacrolimus in preventing transplant rejection in Chinese patients – optimizing use