Cyclosporine or tacrolimus: which is the better partner for myfortic or cellcept?
BACKGROUND
Mycophenolic acid (MPA) pharmacokinetics using the mycophenolate mofetil (CellCept) formulation are known to differ between patients receiving tacrolimus (FK) or cyclosporine (CyA), but only limited data exist concerning concomitant use of FK or CyA with enteric-coated mycophenolate sodium (EC-MPS; Myfortic). This retrospective study compared the drug interactions with the mycophenolic acid blood levels using different immunosuppressants and their relation to graft survival.


METHODS
We studied MPA levels in posttransplant sera from 298 renal transplant recipients.


RESULTS
Patients receiving immunosuppression with CyA + Myfortic showed 94% at 5- and 10-year graft survivals, which were better than CyA + CellCept (75%, 63%). This combination suppressed posttransplant human leukocyte antigen (HLA) antibody development significantly (P = .03) with higher MPA levels.


CONCLUSIONS
Patients immunosuppressed with CyA + Myfortic showed higher MPA levels and lower posttransplant HLA antibody development as well as the best graft survival. CyA + Myfortic or FK + Cellcept may be better combinations.
Department of Surgery, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan. pochang@mail.ncku.edu.tw
P-C
PC
Lee
S-S
SS
Chang
S-C
SC
Shieh
Z-C
ZC
Wu
W-M
WM
Wang
J-D
JD
Wang
C-J
CJ
Hung
Y-J
YJ
Lin
T-C
TC
Chou
R-H
RH
Chan
D016572:Cyclosporine / Q000627:therapeutic use*; D004347:Drug Interactions; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D013624:Taiwan; D016896:Treatment Outcome
D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus