Therapeutic monitoring of mycophenolate mofetil in organ transplant recipients is it necessary?

• Published in: Clinical pharmacokinetics 2002, Vol.41 (5), p.319-327
• Main Authors: MOURAD, Michel, WALLEMACQ, Pierre, KÖNIG, Josiane, HENRY DE FRAHAN, Evelyne, DJAMILA CHAIB EDDOUR, DE MEYER, Martine, MALAISE, Jacques, SQUIFFLET, Jean Paul
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Drug Monitoring - methods; Drug Monitoring - statistics & numerical data; Graft Rejection - drug therapy; Graft Rejection - metabolism; Humans; Immunomodulators; Immunosuppressive Agents - pharmacokinetics; Immunosuppressive Agents - therapeutic use; Medical sciences; Monitoring, Immunologic - methods; Monitoring, Immunologic - statistics & numerical data; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - pharmacokinetics; Mycophenolic Acid - therapeutic use; Pharmacology. Drug treatments
• ISSN: 0312-5963; 1179-1926
• DOI: 10.2165/00003088-200241050-00001

Adequate immunosuppression minimising the risk of organ rejection with acceptable tolerability of the used drugs is a crucial step in organ transplantation. The primary goal is to maintain a consistent time-dependent target concentration by tailoring individual dosage leading to the best efficacy and tolerability combination. The use of therapeutic drug monitoring (TDM) to optimise immunosuppressive therapy is routinely employed for maintenance drugs such as cyclosporin and tacrolimus. The question whether therapeutic monitoring of mycophenolic acid (MPA) in organ transplant recipients treated with mycophenolate mofetil is necessary is not definitely answered. The correlation of mycophenolic acid pharmacokinetic parameters with efficacy and toxicity makes the therapeutic monitoring of this drug promising. However, further studies are mandatory to draw the best guidelines in order to achieve higher levels of evidence that MPA-TDM may improve patient outcome.