Therapeutic monitoring of mycophenolate mofetil in organ transplant recipients: is it necessary?
Adequate immunosuppression minimising the risk of organ rejection with acceptable tolerability of the used drugs is a crucial step in organ transplantation. The primary goal is to maintain a consistent time-dependent target concentration by tailoring individual dosage leading to the best efficacy and tolerability combination. The use of therapeutic drug monitoring (TDM) to optimise immunosuppressive therapy is routinely employed for maintenance drugs such as cyclosporin and tacrolimus. The question whether therapeutic monitoring of mycophenolic acid (MPA) in organ transplant recipients treated with mycophenolate mofetil is necessary is not definitely answered. The correlation of mycophenolic acid pharmacokinetic parameters with efficacy and toxicity makes the therapeutic monitoring of this drug promising. However, further studies are mandatory to draw the best guidelines in order to achieve higher levels of evidence that MPA-TDM may improve patient outcome.
Mourad
Michel
M
Department of Kidney and Pancreas Transplantation, University Hospital Saint Luc, Université Catholique de Louvain, Brussels, Belgium. Michel.Mourad@chir.ucl.ac.be
Wallemacq
Pierre
P
König
Josiane
J
de Frahan
Evelyne Henry
EH
Eddour
Djamila Chaib
DC
De Meyer
Martine
M
Malaise
Jacques
J
Squifflet
Jean Paul
JP
D016903:Drug Monitoring / Q000379:methods* / Q000706:statistics & numerical data; D006084:Graft Rejection / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015166:Monitoring, Immunologic / Q000379:methods* / Q000706:statistics & numerical data; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid