Towards therapeutic drug monitoring of mycophenolic acid in mucous membrane pemphigoid: A retrospective single‐centre study

Abstract

Background: Mycophenolate mofetil (MMF) is theoretically a treatment of choice for mucous membrane pemphigoid (MMP), due to its good long-term tolerance and efficacy especially in elderly patients. However, no therapeutic monitoring is currently performed despite its large inter-individual variability. Objectives:The aim of this study was to investigate the exposure/effect relationship based on the area under the curve (AUC) or trough level of mycophenolic acid in MMP patients.Methods: Thirteen patients (n = 29 AUC measurements performed between

Population pharmacokinetics and Bayesian estimation of mycophenolate mofetil in patients with autoimmune hepatitis

“…Although there is no established exposure target for MPA in AIH patients, interindividual variability (IIV) of MPA pharmacokinetic (PK) parameters among patients with autoimmune diseases has been shown to be as high as among transplant patients and statistical association was observed between MPA levels and recurrence of active disease in patients with other autoimmune diseases 14–17 …”

“…In children with a nephrotic syndrome, several studies showed that patients with AUC 0–12h > 45 mg h/L had a lowed relapse rate 34–37 . In bullous skin diseases, 45 mg h/L has also been proposed as an exposure target 17 …”

“…12 Although there is no established exposure target for MPA in AIH patients, interindividual variability (IIV) of MPA pharmacokinetic (PK) parameters among patients with autoimmune diseases has been shown to be as high as among transplant patients and statistical association was observed between MPA levels and recurrence of active disease in patients with other autoimmune diseases. [14][15][16][17] Therefore, reliable strategy and tools should make it possible to secure MMF treatment by individualizing the dose according not only to patient response to treatment but also to patient exposure, as recommended in transplantation and already for other autoimmune diseases. This would shrink the differences in MPA exposure among patients.…”

“…[34][35][36][37] In bullous skin diseases, 45 mg h/L has also been proposed as an exposure target. 17 The objective of the present study was to develop methods to estimate MPA AUC 0-12h in AIH patients administered MMF, through population PK modelling and maximum a posteriori Bayesian estimation (MAP-BE) based on a limited sampling strategy (LSS).…”