The impact of mycophenolate mofetil dosing patterns on clinical outcome after renal transplantation
The impact of mycophenolate mofetil dosing patterns on clinical outcome after renal transplantation
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DOI：
10.1034/j.1399-0012.2003.00026.x
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发表时间：
2003-06-01
影响因子：
2.1
通讯作者：
Ferguson, RM
中科院分区：
文献类型：
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作者：
Pelletier, RP;Akin, B;Ferguson, RM
背景：吗替麦考酚酯 (MMF) 已被证明是一种非常有效的药物，用于预防肾移植后急性排斥反应，按处方剂量服用 2 或 3 g/d。然而，在临床移植中，有时会出现必须降低剂量的情况，以避免药物毒性或并发感染。之前尚未研究过必须降低 MMF 剂量时对急性排斥反应发生率和移植物存活的影响。 方法：在本研究中，对接受 MMF 联合环孢素和泼尼松以及 OKT3 (n=425) 或 Simulect (n=296) 诱导免疫抑制的 721 名肾移植受者进行了评估。对移植后第一年内有和没有 MMF 剂量变化的患者的临床结果进行比较和对比。结果：大多数患者 (70.3%，n=507) 在移植后第一年内至少有一次剂量变化。与 214 名没有改变剂量的患者相比，这些患者在移植后第一年内的急性排斥反应发生率要高得多（23.3% vs. 3.7%，p
Background: Mycophenolate mofetil (MMF) has proven to be a very effective drug for the prevention of acute rejection following renal transplantation when dosed as prescribed at 2 or 3 g/d. However, circumstances arise in clinical transplantation where the dose must be lowered, either to avoid drug toxicity or because of concurrent infection. The impact on the incidence of acute rejection and graft survival when the MMF dose must be lowered has not previously been investigated.Methods: In this study, a cohort of 721 kidney transplant recipients who received immunosuppression using MMF in conjunction with cyclosporine and prednisone and OKT3 (n=425) or Simulect (n=296) induction were evaluated. Clinical outcomes were compared and contrasted between patients with and without MMF dose changes within the first year post-transplantation.Results: The majority of patients (70.3%, n=507) had at least one dose change within the first post-transplant year. Compared with the 214 patients who did not have a dose change, these patients had a much higher incidence of acute rejection within the first post-transplant year (23.3% vs. 3.7%, p