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NDT Advance Access originally published online on September 9, 2008
Nephrology Dialysis Transplantation 2008 23(11):3386-3388; doi:10.1093/ndt/gfn497
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Therapeutic drug monitoring for mycophenolic acid in patients with autoimmune diseases

Brenda C. M. de Winter1 and Teun van Gelder1,2

1 Department of Hospital Pharmacy 2 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

Correspondence and offprint requests to: Teun van Gelder, Department of Hospital Pharmacy, Clinical Pharmacology Unit, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Tel: +31-10-703-3202; Fax: +31-10-703-2400; E-mail: t.vangelder@erasmusmc.nl

Keywords: auto-immune disease; lupus; mycophenolic acid; therapeutic drug monitoring

The first 150 words of the full text of this article appear below.



   Introduction
 
Mycophenolate mofetil (MMF, CellCept®) has become the most frequently used immunosuppressive drug in kidney transplant recipients [1]. Since its approval for the prevention of acute rejection after kidney transplantation in 1995 in the USA and in 1996 in Europe, the use of azathioprine has been rapidly diminishing, giving way to the use of MMF. A second formulation of mycophenolic acid (MPA), the active metabolite of MMF, has become available as enteric-coated mycophenolate sodium (EC-MPS, Myfortic®). Randomized clinical trials have shown that EC-MPS 720 mg b.i.d. is therapeutically equivalent to MMF 1000 mg b.i.d. with a comparable safety profile [2,3]. These equimolar doses of EC-MPS and MMF produce equivalent MPA exposure. The delayed release formulation, EC-MPS, exhibits more variable pre-dose MPA concentrations and more variable peak concentrations [4].

Because of the favourable experience with MMF in transplant recipients, combining good efficacy with relatively few . . . [Full Text of this Article]



   Lupus nephritis
 


   ANCA-associated vasculitis
 


   Optimal dosing
 


   Correlating MPA exposure to clinical outcome
 


   Unanswered questions
 


   What can we do now?
 


   Conclusion
 

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