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Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy

BACKGROUNDS/AIMS: Mycophenolate mofetil (MMF) has wide inter- and intra-individual variability of mycophenolic acid (MPA) after liver transplantation (LT). On this study, we aimed to analyse the intra-individual variability of MPA concentration in stable adult LT recipients receiving MMF monotherapy...

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Autores principales: Hwang, Shin, Song, Gi-Won, Jung, Dong-Hwan, Park, Gil-Chun, Ahn, Chul-Soo, Moon, Deok-Bog, Ha, Tae-Yong, Kim, Ki-Hun, Lee, Sung-Gyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association of Hepato-Biliary-Pancreatic Surgery 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353912/
https://www.ncbi.nlm.nih.gov/pubmed/28317040
http://dx.doi.org/10.14701/ahbps.2017.21.1.11
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author Hwang, Shin
Song, Gi-Won
Jung, Dong-Hwan
Park, Gil-Chun
Ahn, Chul-Soo
Moon, Deok-Bog
Ha, Tae-Yong
Kim, Ki-Hun
Lee, Sung-Gyu
author_facet Hwang, Shin
Song, Gi-Won
Jung, Dong-Hwan
Park, Gil-Chun
Ahn, Chul-Soo
Moon, Deok-Bog
Ha, Tae-Yong
Kim, Ki-Hun
Lee, Sung-Gyu
author_sort Hwang, Shin
collection PubMed
description BACKGROUNDS/AIMS: Mycophenolate mofetil (MMF) has wide inter- and intra-individual variability of mycophenolic acid (MPA) after liver transplantation (LT). On this study, we aimed to analyse the intra-individual variability of MPA concentration in stable adult LT recipients receiving MMF monotherapy and develop a method to determine the target level in the situation of wide intra-individual variability. METHODS: This retrospective cross-sectional study included 30 LT recipients. All patients received MMF monotherapy at a dose of 500 mg twice daily for ≥2 years and were divided into two groups based on renal function. MPA concentration-associated values were presented as mean with standard deviation and coefficient of variation (CV). RESULTS: The normal renal function group (n=15) showed a mean 12-hour MPA concentration of 2.5±0.5 µg/ml (range, 1.8±0.5 to 3.6±0.7 µg/ml) and a mean CV of 20.4±7.7% (range, 8.7% to 39.4%). In the renal dysfunction group (n=15), the 12-hour MPA concentration fluctuated more widely with a mean value of 3.7±0.9 µg/ml (range, 2.8±0.8 to 5.1±1.2 µg/ml) and a mean CV of 24.5±4.9% (range, 17.1% to 37.5%). The 12-hour MPA concentration was significantly higher in the renal dysfunction group, as compared to the normal renal function group (p=0.001); whereas, the CV was not significantly different between the two groups (p=0.093). CONCLUSIONS: We determined the inter- and intra-individual variability of 12-hour MPA concentration after LT. The results suggested that therapeutic drug monitoring of MPA is necessary due to the inter-individual and intra-individual variability of MMF pharmacokinetics, especially in LT recipients with renal dysfunction.
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spelling pubmed-53539122017-03-17 Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy Hwang, Shin Song, Gi-Won Jung, Dong-Hwan Park, Gil-Chun Ahn, Chul-Soo Moon, Deok-Bog Ha, Tae-Yong Kim, Ki-Hun Lee, Sung-Gyu Ann Hepatobiliary Pancreat Surg Original Article BACKGROUNDS/AIMS: Mycophenolate mofetil (MMF) has wide inter- and intra-individual variability of mycophenolic acid (MPA) after liver transplantation (LT). On this study, we aimed to analyse the intra-individual variability of MPA concentration in stable adult LT recipients receiving MMF monotherapy and develop a method to determine the target level in the situation of wide intra-individual variability. METHODS: This retrospective cross-sectional study included 30 LT recipients. All patients received MMF monotherapy at a dose of 500 mg twice daily for ≥2 years and were divided into two groups based on renal function. MPA concentration-associated values were presented as mean with standard deviation and coefficient of variation (CV). RESULTS: The normal renal function group (n=15) showed a mean 12-hour MPA concentration of 2.5±0.5 µg/ml (range, 1.8±0.5 to 3.6±0.7 µg/ml) and a mean CV of 20.4±7.7% (range, 8.7% to 39.4%). In the renal dysfunction group (n=15), the 12-hour MPA concentration fluctuated more widely with a mean value of 3.7±0.9 µg/ml (range, 2.8±0.8 to 5.1±1.2 µg/ml) and a mean CV of 24.5±4.9% (range, 17.1% to 37.5%). The 12-hour MPA concentration was significantly higher in the renal dysfunction group, as compared to the normal renal function group (p=0.001); whereas, the CV was not significantly different between the two groups (p=0.093). CONCLUSIONS: We determined the inter- and intra-individual variability of 12-hour MPA concentration after LT. The results suggested that therapeutic drug monitoring of MPA is necessary due to the inter-individual and intra-individual variability of MMF pharmacokinetics, especially in LT recipients with renal dysfunction. Korean Association of Hepato-Biliary-Pancreatic Surgery 2017-02 2017-02-28 /pmc/articles/PMC5353912/ /pubmed/28317040 http://dx.doi.org/10.14701/ahbps.2017.21.1.11 Text en Copyright © 2017 by The Korean Association of Hepato-Biliary-Pancreatic Surgery http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hwang, Shin
Song, Gi-Won
Jung, Dong-Hwan
Park, Gil-Chun
Ahn, Chul-Soo
Moon, Deok-Bog
Ha, Tae-Yong
Kim, Ki-Hun
Lee, Sung-Gyu
Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title_full Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title_fullStr Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title_full_unstemmed Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title_short Intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
title_sort intra-individual variability of mycophenolic acid concentration according to renal function in liver transplant recipients receiving mycophenolate monotherapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353912/
https://www.ncbi.nlm.nih.gov/pubmed/28317040
http://dx.doi.org/10.14701/ahbps.2017.21.1.11
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