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Gastrointestinal side effects in liver transplant recipients taking enteric-coated mycophenolate sodium vs.

Roberto Lopez-Solis1, Michael DeVera, Jennifer Steel

  • 1Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Clinical Transplantation
|April 24, 2014
PubMed

Insights

Enteric-coated mycophenolate sodium (EC-MPS) showed improved gastrointestinal (GI) symptoms in liver transplant patients previously treated with mycophenolate mofetil (MMF). A de novo study found no significant difference in GI side effects between EC-MPS and MMF.

Area of Science:

  • Immunology
  • Pharmacology
  • Transplantation Medicine

Background:

  • Mycophenolate mofetil (MMF) is an immunosuppressant used in liver transplantation.
  • Severe gastrointestinal (GI) side effects can limit MMF use.
  • Enteric-coated mycophenolate sodium (EC-MPS) may offer better tolerability.

Purpose of the Study:

  • To compare the GI side effects of EC-MPS and MMF in liver transplant recipients.
  • To evaluate EC-MPS tolerability in de novo and conversion settings.

Main Methods:

  • Two studies were conducted: a de novo randomized, prospective, double-blinded study (Study I) and a conversion study (Study II).
  • Gastrointestinal Symptoms Rating Scale (GSRS) was used to assess GI symptoms (pain, reflux, indigestion, diarrhea, constipation).
  • Study I compared 15 EC-MPS recipients to 15 MMF recipients; Study II involved 29 patients converting from MMF to EC-MPS.

Main Results:

  • Study I revealed no significant difference in total GSRS scores or symptom subscores between EC-MPS and MMF (p > 0.05).
  • Study II demonstrated significant improvement in all GI symptoms over time after conversion from MMF to EC-MPS (p < 0.001).

Conclusions:

  • While de novo EC-MPS did not show superior GI tolerability compared to MMF in Study I, conversion to EC-MPS significantly improved GI symptoms in Study II.
  • EC-MPS may be a viable option for liver transplant patients experiencing GI side effects with MMF.
Keywords:
Gastrointestinal Symptoms Rating Scaleenteric-coatedimmunosuppressionliver transplantationmycophenolate mofetilmycophenolate sodium

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