title: Limited sampling strategy for predicting area under the concentration-time curve for mycophenolic Acid in Chinese adults receiving mycophenolate mofetil and tacrolimus early after renal transplantation.
abstract: BACKGROUND
  The objective of the study was to investigate the pharmacokinetics of mycophenolate mofetil (MMF) in Chinese adults early after renal transplantation by an enzyme multiplied immunoassay technique and to establish a limited sampling strategy to predict the area under the concentration-time curve for plasma levels of mycophenolic acid (MPA-AUC).
  
  
  METHODS
  Fifty-eight recipients who underwent renal transplantation with an organ donated after cardiac death used a triple immunosuppressant strategy of MMF, tacrolimus, and prednisone. On the seventh day posttransplantation, plasma samples were collected at 0 hours (pre-dose) and at 0.5, 1, 1.5, 2, 4, 6, 8, 10, and 12 hours postdose (C0h, C0.5h, C1h, C1.5h, C2h, C4h, C6h, C8h, C10h, and C12h, respectively). Enzyme multiplied immunoassay technique was used to measure mycophenolic acid concentration, and model equations were generated by multiple stepwise regression analysis to determine MPA-AUC0-12h.
  
  
  RESULTS
  The 3-point equation obtained by multiple linear regression analysis was MPA-AUC = 7.951 + 4.04C6h + 1.893C2h + 4.542C10h (adjusted r = 0.863); the 4-point equation was MPA-AUC = 4.272 + 4.074C6h + 1.896C2h + 4.680C10h + 0.859C0.5h (adjusted r = 0.918). The % mean prediction error, % mean absolute error, and % root mean squared prediction error for the best-fit formula using C6h, C2h, C10h, and C0.5h were -0.2%, 8.7%, and 14.2%, respectively.
  
  
  CONCLUSIONS
  In Chinese adults receiving MMF and tacrolimus early after renal transplantation, the best equation for predicting MPA-AUC0-12h is 4.272 + 4.074C6h + 1.896C2h + 4.680C10h + 0.859C0.5h.
authors.affiliation: *Guangxi Key Laboratory of Transplant Medicine, Institute of Transplant Medicine, Nanning; and †Department of Diagnosis, Administration of Old Officer of Beiji Temple, Beijing, China.
authors.forename: Wene
authors.initials: W
authors.lastname: Cai
authors.forename: Changqing
authors.initials: C
authors.lastname: Ye
authors.forename: Xuyong
authors.initials: X
authors.lastname: Sun
authors.forename: Ke
authors.initials: K
authors.lastname: Qin
authors.forename: Yinhong
authors.initials: Y
authors.lastname: Qin
authors.forename: Donghai
authors.initials: D
authors.lastname: Zhao
authors.forename: Fengfu
authors.initials: F
authors.lastname: Wu
authors.forename: Yun
authors.initials: Y
authors.lastname: Hu
authors.forename: Haibin
authors.initials: H
authors.lastname: Li
authors.forename: Luojiao
authors.initials: L
authors.lastname: Tan
mesh_terms: D000328:Adult; D019540:Area Under Curve; D044466:Asian People; D016903:Drug Monitoring / Q000379:methods*; D004359:Drug Therapy, Combination; D017248:Enzyme Multiplied Immunoassay Technique; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics*; D016030:Kidney Transplantation / Q000379:methods*; D016014:Linear Models; D008297:Male; D008954:Models, Biological; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000097:blood* / Q000493:pharmacokinetics; D011241:Prednisone / Q000627:therapeutic use; D016559:Tacrolimus / Q000097:blood / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus