Benefits of conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in pediatric renal transplant patients with stable graft function.
Conversion from MMF to EC-MPS may reduce GI complications and permit increased MPA dosing with a concomitant reduction in CNI dose. In a prospective trial, paediatric renal transplant patients with stable graft function were converted from MMF to EC-MPS and followed-up for 12 months. Data from 28 patients (mean age 13.9 +/- 3.1 yr) were available for analysis. Mean EC-MPS dose increased significantly from conversion to month 12 (668 +/- 81 mg/m(2)/day vs. 747 +/- 98 mg/m(2)/day, p < 0.001). CsA-ME dose (n = 23) decreased from 5.3 +/- 1.7 mg/kg/day at conversion to 4.6 +/- 1.4 mg/kg/day at month 12 (p = 0.010). cGFR increased from 69.5 +/- 23.3 mL/min/1.73 m(2) at the time of conversion to 80.7 +/- 30.7 mL/min/1.73 m(2) at month 12 (p = 0.007). The number of patients reporting at least one GI event during six months prior to conversion was 15/28 (53.6%), declining to 8/28 (28.6%) at month 6 post-conversion and 5/28 (17.8%) at month 12. This single-arm study suggests that conversion of paediatric renal transplant patients from MMF to EC-MPS does not compromise efficacy and leads to improved GI tolerability. MPA dose increased and CsA-ME dose decreased significantly, with an associated improvement in calculated GFR. A large-scale controlled trial is required to confirm these promising findings.
Meneses
Rejane de Paula
Rde P
Division of Pediatric Nephrology, Hospital Pequeno Príncipe, Rua Desembargador Motta 1070, Curitiba, Paraná, Brazil. rejanemeneses@onda.com.br
Kotsifas
Cecília Halusch
CH
D000293:Adolescent; D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000378:metabolism / Q000627:therapeutic use*; D011446:Prospective Studies; D013608:Tablets, Enteric-Coated / Q000627:therapeutic use*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013608:Tablets, Enteric-Coated; D009173:Mycophenolic Acid