Population pharmacokinetics of mycophenolate in patients treated for interstitial lung disease (EVER-ILD study)

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Pulmonary Medicine

Background:

• Mycophenolate mofetil (MMF) is used for interstitial lung disease (ILD).
• Mycophenolate (MPA) pharmacokinetics in ILD patients remains undescribed.
• This study addresses the pharmacokinetic variability of MPA in ILD.

Purpose of the Study:

• To describe mycophenolate (MPA) pharmacokinetics in interstitial lung disease (ILD) patients.
• To utilize population modeling for understanding MPA variability in ILD.
• To provide foundational pharmacokinetic data for MPA in ILD treatment.

Main Methods:

• Population pharmacokinetic modeling was applied to 27 ILD patients receiving MMF 1000 mg twice daily.
• MPA concentrations were measured over an 8-hour period.
• Two-compartment and gamma absorption models were used to describe MPA absorption, distribution, and elimination.

Main Results:

• MPA pharmacokinetics in ILD was best described by a two-compartment model with two gamma absorption models.
• Key factors influencing MPA pharmacokinetics included body weight, renal function, and inflammatory status.
• The median area under the concentration-time curve (AUC12) was 52.5 mg·h/L.

Conclusions:

• This is the first report on MPA pharmacokinetics specifically in ILD patients.
• The observed MPA pharmacokinetics appear comparable to those in other patient populations.
• Further research is warranted to fully elucidate MPA pharmacokinetics and optimize its use in ILD.