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Benefits of conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in pediatric renal

Rejane de Paula Meneses1, Cecília Halusch Kotsifas

  • 1Division of Pediatric Nephrology, Hospital Pequeno Príncipe, Rua Desembargador Motta 1070, Curitiba, Paraná, Brazil. rejanemeneses@onda.com.br

Pediatric Transplantation
|August 5, 2008
PubMed

Insights

Converting pediatric renal transplant patients from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) improved gastrointestinal tolerability and enhanced calculated glomerular filtration rate (cGFR). This switch also allowed for increased mycophenolic acid (MPA) dosing and reduced calcineurin inhibitor (CNI) doses.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Gastrointestinal (GI) complications are common with mycophenolate mofetil (MMF) in pediatric renal transplant recipients.
  • Optimizing immunosuppression while minimizing side effects is crucial for long-term graft survival.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of switching from MMF to enteric-coated mycophenolate sodium (EC-MPS) in pediatric renal transplant patients.
  • To assess changes in immunosuppressant dosing and renal function post-conversion.

Main Methods:

  • A prospective, single-arm study involving 28 pediatric renal transplant patients.
  • Patients were converted from MMF to EC-MPS and followed for 12 months.
  • Data on drug dosage, GI events, and calculated glomerular filtration rate (cGFR) were collected.

Main Results:

  • Mean EC-MPS dose increased significantly, while calcineurin inhibitor (CNI) doses (cyclosporine microemulsion, CsA-ME) decreased.
  • The incidence of GI events significantly declined post-conversion.
  • Calculated GFR (cGFR) showed a significant improvement at 12 months post-conversion.

Conclusions:

  • Conversion from MMF to EC-MPS in pediatric renal transplant patients is safe and effective.
  • This switch improves GI tolerability and renal function without compromising graft efficacy.
  • Further large-scale controlled trials are warranted to confirm these findings.

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