title: Comparison of the exposure of mycophenolate mofetil and enteric-coated mycophenolate sodium in recipients of kidney-pancreas transplantation.
abstract: BACKGROUND
  Patients with a simultaneous pancreas-kidney transplant (SPKT), especially those with gastroparesis, often have gastro-intestinal (GI) disorders that can modify immunosuppressant pharmacokinetics. We compared the MPA 12-hours area under the curve (AUC(0-12)) in SKPT patients with severe gastroparesis receiving mycophenolate mofetil (MMF) or enteric-coated mycophenolate sodium (EC-MPS).
  
  
  METHODS
  Fifteen SKPT patients having a severe gastroparesis were switched, at 182 (69-1523) days post-transplantation, from MMF to EC-MPS because of GI disorders. MPA AUC(0-12) values were obtained before and after the switch, ie, under MMF (500 mg b.i.d.) at 169 (51-1522) days post-transplantation and EC-MPS (360 mg b.i.d.) at 102 (26-355) days after the switch.
  
  
  RESULTS
  Mean MPA AUC(0-12) h did not differ significantly under MMF and EC-MPS, ie, 40.13±14 and 38.24±15.5 mg*h/L, respectively. Trough and maximal MPA concentrations were similar with both MPA formulations. Although all patients had GI disorders under MMF (100%), only 3 had persistent GI disorders under EC-MPS (20%) (p<0.001).
  
  
  CONCLUSIONS
  In SKPT patients with severe gastroparesis, exposure to MPA is similar under MMF and EC-MPS. However, the incidence of GI disorders is significantly lower when patients are given EC-MPS.
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors: Julie
authors: J
authors: Belliere
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors: Laure
authors: L
authors: Esposito
authors: University Paul Sabatier, Toulouse, France.
authors: Peggy
authors: P
authors: Gandia
authors: Department of Digestive Surgery, CHU Rangueil, Toulouse, France.
authors: Jean Pierre
authors: JP
authors: Duffas
authors: Department of Urology and Kidney Transplantation, CHU Rangueil, Toulouse, France.
authors: Federico
authors: F
authors: Sallusto
authors: Department of Nephrology and Organ Transplantation, CHU Ranguei, Toulouse, France.
authors: Isabelle
authors: I
authors: Cardeau-Desangles
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors: Arnaud
authors: A
authors: Del Bello
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors: Lionel
authors: L
authors: Rostaing
authors: Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
authors: Nassim
authors: N
authors: Kamar
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018589:Gastroparesis / Q000188:drug therapy; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D013608:Tablets, Enteric-Coated / Q000008:administration & dosage / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013608:Tablets, Enteric-Coated; D009173:Mycophenolic Acid