title: Comparative pharmacokinetic study of two mycophenolate mofetil formulations in stable kidney transplant recipients.
abstract: We compared steady-state pharmacokinetics of mycophenolate mofetil (MMF) - Myfenax(®) (Teva) and CellCept(®) (Roche) - in stable kidney transplant recipients (KTRs). This was an international, multi-centre, randomized, open-label, two-treatment, two-sequence crossover study with a 3-month follow-up. We included KTRs at least 12 months post-transplantation with stable renal graft function for at least 3 months. The maintenance treatment consisted of MMF in combination with tacrolimus with or without steroids. At the end of the two treatment periods, 6-h or 12-h PK studies of mycophenolic acid (MPA) were performed. A total of 43 patients (mean age: 50.7 ± 13.5 years; 19 females, 24 males) were randomized. Estimates of test to reference ratios (90% CIs) were 0.959 (0.899; 1.023) h*μg/ml for AUC((0-tau)) and 0.873 (0.787; 0.968) μg/ml for C(max). Estimates for AUC((0-6h)) were 0.923 (0.865; 0.984) h*μg/ml and 0.985 (0.877; 1.106) μg/ml for C(min). Thus, AUC((0-tau)), AUC((0-6h)), and C(min) of MPA were within the predefined margins. C(max) was somewhat outside of these margins in this set of patients. The numbers and types of adverse events were not different between the two treatments. The steady-state pharmacokinetics of MPA as well as adverse events are comparable for Myfenax(®) and CellCept(®) in tacrolimus-treated stable KTRs.
authors.affiliation: Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Austria. gere.sunder-plassmann@meduniwien.ac.at
authors.forename: Gere
authors.initials: G
authors.lastname: Sunder-Plassmann
authors.forename: Petra
authors.initials: P
authors.lastname: Reinke
authors.forename: Thomas
authors.initials: T
authors.lastname: Rath
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.forename: Michal
authors.initials: M
authors.lastname: Nowicki
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.forename: Jens
authors.initials: J
authors.lastname: Lutz
authors.forename: Martina
authors.initials: M
authors.lastname: Gaggl
authors.forename: Marek
authors.initials: M
authors.lastname: Ferkl
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001682:Biological Availability; D002626:Chemistry, Pharmaceutical; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus