Mycophenolate mofetil

Lipsky, James J.

doi:10.1016/s0140-6736(96)10310-x

Cited by 298 publications

(167 citation statements)

References 23 publications

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“…Diarrhea occurs more frequently as an adverse effect of MMF in patients treated with TAC. [27][28][29] We suggest that estimating biliary excretion of MPAG is needed to avoid the risk of intestinal injury in combination therapy with TAC during the maintenance period.…”

Section: Discussionmentioning

confidence: 99%

Effects of Calcineurin Inhibitors on Pharmacokinetics of Mycophenolic Acid and Its Glucuronide Metabolite during the Maintenance Period Following Renal Transplantation

Naito

Shinno

Maeda

et al. 2006

Biological & Pharmaceutical Bulletin

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Mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil (MMF) has been introduced into renal transplant immunosuppressant protocols in combination with calcineurin inhibitors (CNIs) and steroids. This study compared the pharmacokinetic profiles of MPA and its major metabolite MPA glucuronide (MPAG) in combination with tacrolimus (TAC) or cyclosporine (CyA) during the maintenance period (Ͼ6 months) following renal transplantation. There was no difference between TAC and CyA-treated groups in MPA plasma concentration before drug administration (C 0 ). MPA C 0 in TAC and CyA-treated patients did not differ from that in patients who were not treated with a CNI. In patients treated with a CNI, MPAG C 0 was significantly greater in those treated with CyA compared with TAC. The MPAG/MPA ratio in CyA-treated patients was significantly greater than that in the TAC-treated group. We observed that C 0 of MPA was negatively correlated with that of TAC and CyA. Positive correlation between MPA C 0 , MPAG C 0 and serum creatinine was stronger in patients treated with CyA compared with TAC. Our study suggests that CyA, but not TAC, inhibits enterohepatic circulation of MPAG as a secondary excretion pathway, and that renal function makes a major contribution to elimination of MPA and MPAG. We indicate that it may be necessary to estimate biliary excretion of MPAG to avoid the risk of intestinal injury in patients receiving combination therapy with TAC during the maintenance period.

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Section: Discussionmentioning

confidence: 99%

Effects of Calcineurin Inhibitors on Pharmacokinetics of Mycophenolic Acid and Its Glucuronide Metabolite during the Maintenance Period Following Renal Transplantation

Naito

Shinno

Maeda

et al. 2006

Biological & Pharmaceutical Bulletin

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“…Mycophenolate mofetil is a small-molecule prodrug used to prevent rejection of organ transplants (283). It is metabolized by the liver to become mycophenolic acid, which blocks B and T cell proliferation by inhibiting IMP dehydrogenase and preventing purine synthesis (407).…”

Section: Immunomodulatory Therapies and Pmlmentioning

confidence: 99%

Molecular Biology, Epidemiology, and Pathogenesis of Progressive Multifocal Leukoencephalopathy, the JC Virus-Induced Demyelinating Disease of the Human Brain

et al. 2012

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SUMMARY Progressive multifocal leukoencephalopathy (PML) is a debilitating and frequently fatal central nervous system (CNS) demyelinating disease caused by JC virus (JCV), for which there is currently no effective treatment. Lytic infection of oligodendrocytes in the brain leads to their eventual destruction and progressive demyelination, resulting in multiple foci of lesions in the white matter of the brain. Before the mid-1980s, PML was a relatively rare disease, reported to occur primarily in those with underlying neoplastic conditions affecting immune function and, more rarely, in allograft recipients receiving immunosuppressive drugs. However, with the onset of the AIDS pandemic, the incidence of PML has increased dramatically. Approximately 3 to 5% of HIV-infected individuals will develop PML, which is classified as an AIDS-defining illness. In addition, the recent advent of humanized monoclonal antibody therapy for the treatment of autoimmune inflammatory diseases such as multiple sclerosis (MS) and Crohn's disease has also led to an increased risk of PML as a side effect of immunotherapy. Thus, the study of JCV and the elucidation of the underlying causes of PML are important and active areas of research that may lead to new insights into immune function and host antiviral defense, as well as to potential new therapies.

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“…Its use is still burdened with significant toxicity, so that, in recent years, its use was reduced. The comparison studies, performed both in ANCA associated vasculitis that in lupus glomerulonephritis, including AZA and mycophenolate mofetil (MMF) have reported equivalent results in terms of effectiveness, but most of the toxicity of AZA compared with MMF [1,[32][33][34][35][36].…”

Section: Antimetabolites Azathioprinementioning

confidence: 99%

Glomerulonephritis, Pathogenetic Mechanisms and Therapeutic Options: An Overview

Russo

Musto²,

Testorio³

et al. 2014

J Nephrol Ther

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Introduction: Most forms of human glomerulonephritis (GN) result from immunologic mechanisms that are mediated by the actions of multiple elements of both the innate and adaptive immune systems, thereby resulting in different clinical manifestations. The treatment of immune-mediated kidney disease is based on steroids and immunosuppressive drugs that interfere with the immune processes. These groups of drugs have led to significant benefits, but severe side effects are still frequent. Monoclonal antibodies directed against molecules of inflammation or several cellular components have emerged in clinical practice. Plasmapheresis and new methods to reduce the risks associated with the procedure with standard therapies may be combined. Moreover new therapeutic options have been proposed, as the use of natural anti-inflammatory cytokines or intracellular signaling reducing inflammation.

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Mycophenolate mofetil

Cited by 298 publications

References 23 publications

Effects of Calcineurin Inhibitors on Pharmacokinetics of Mycophenolic Acid and Its Glucuronide Metabolite during the Maintenance Period Following Renal Transplantation

Effects of Calcineurin Inhibitors on Pharmacokinetics of Mycophenolic Acid and Its Glucuronide Metabolite during the Maintenance Period Following Renal Transplantation

Molecular Biology, Epidemiology, and Pathogenesis of Progressive Multifocal Leukoencephalopathy, the JC Virus-Induced Demyelinating Disease of the Human Brain

Glomerulonephritis, Pathogenetic Mechanisms and Therapeutic Options: An Overview

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