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Improved gastrointestinal symptom burden after conversion from mycophenolate mofetil to enteric-coated mycophenolate

Lars Pape1, Thurid Ahlenstiel, Martin Kreuzer

  • 1Department of Pediatric Nephrology, Medical School of Hannover, Germany. larspape@t-online.de

Pediatric Transplantation
|September 18, 2008
PubMed

Insights

Switching mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) significantly eased gastrointestinal (GI) symptoms in pediatric kidney transplant patients. Graft function remained stable after the conversion.

Area of Science:

  • Pediatric Nephrology
  • Transplant Immunology
  • Gastroenterology

Background:

  • Gastrointestinal (GI) symptoms are a common complication in pediatric kidney transplant recipients treated with mycophenolate mofetil (MMF).
  • Previous studies in adults demonstrated that switching from MMF to enteric-coated mycophenolate sodium (EC-MPS) effectively reduced GI-related symptom burden.
  • No studies have investigated this conversion in pediatric populations experiencing GI issues.

Purpose of the Study:

  • To evaluate the efficacy of converting MMF to EC-MPS in pediatric kidney transplant recipients with moderate to severe GI symptoms.
  • To assess the impact of this conversion on GI symptom severity and graft function.

Main Methods:

  • Ten pediatric kidney transplant recipients on triple immunosuppression (cyclosporine or tacrolimus, MMF, prednisolone) with severe GI symptoms were switched to an equimolar dose of EC-MPS.
  • The Gastrointestinal Symptom Rating Scale (GSRS) was administered before and four weeks after the switch.
  • Glomerular filtration rate (GFR) was monitored for a mean of six months.
  • Paired t-tests were used for statistical comparison.

Main Results:

  • A significant improvement in mean GSRS scores was observed post-conversion, decreasing from 2.1 to 1.1 (p<0.05).
  • Symptom reduction was noted across all four GSRS subscales.
  • One patient did not experience improvement.
  • No significant changes in graft function (GFR) were detected after the conversion.

Conclusions:

  • Conversion from MMF to EC-MPS is a safe and effective strategy for reducing GI symptoms in pediatric kidney transplant recipients.
  • EC-MPS offers a viable alternative for managing GI distress in this patient population without compromising graft function.

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