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Enteric coating of mycophenolate reduces dosage adjustments
1Department of Surgery, Tulane University, New Orleans, Louisiana 70112, USA.
Transplantation Proceedings
|June 24, 2009
Summary
Mycophenolate mofetil (MMF) can cause more gastrointestinal (GI) side effects than enteric-coated mycophenolate sodium (EC-MPS) in kidney transplant patients. This often leads to MMF dosage adjustments, potentially impacting patient compliance and care.
Area of Science:
- Nephrology
- Immunosuppression
- Pharmacology
Background:
- Mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS) are widely used immunosuppressants post-transplantation.
- Gastrointestinal (GI) side effects are a known limitation of MMF therapy.
- Understanding the impact of different mycophenolate formulations on medication adjustments is crucial for patient management.
Purpose of the Study:
- To compare the incidence of GI complications and subsequent medication dosage adjustments between MMF and EC-MPS in kidney transplant recipients.
- To assess the association between MMF use and increased risk of GI-related dosage adjustments.
- To evaluate the impact of these adjustments on other post-transplantation outcomes.
Main Methods:
- Retrospective review of 109 kidney transplant patients.
- Categorization of patients based on initial immunosuppressive therapy: MMF or EC-MPS.
- Analysis of patient-reported GI complications and medication dosage adjustments.
Main Results:
- Higher incidence of GI complications reported in patients receiving MMF (45.5%) compared to EC-MPS (35.3%).
- Significantly greater proportion of MMF patients required dosage adjustments due to GI issues (5.9% vs 2.3%).
- MMF use was strongly associated with GI complications leading to dosage adjustment (odds ratio = 9.9).
Conclusions:
- MMF is associated with a higher likelihood of GI complications necessitating dosage adjustments compared to EC-MPS.
- Increased medication adjustments for MMF may complicate post-transplant care and potentially reduce patient compliance.
- EC-MPS may offer a favorable GI tolerability profile, potentially simplifying immunosuppressive management.
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