The role of mycophenolate mofetil in kidney transplantation revisited

Abstract Since its regulatory approval in 1995, mycophenolate mofetil (MMF) has largely replaced azathioprine (AZA) as the anti-metabolite immunosuppressive of choice in kidney transplantation. While the initial industry-sponsored clinical trials suggested strong reductions in the incidence of acute...

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Bibliographic Details
Published in:Transplantation reviews (Philadelphia, Pa.) Pa.), 2014, Vol.28 (1), p.26-31
Main Authors: Maripuri, Saugar, Kasiske, Bertram L
Format: Article
Language:English
Subjects:
Clinical Trials as Topic
Graft Rejection - drug therapy
Graft Rejection - prevention & control
Humans
Immunosuppressive Agents - therapeutic use
Kidney Transplantation
Mycophenolic Acid - analogs & derivatives
Mycophenolic Acid - therapeutic use
Surgery
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Summary:Abstract Since its regulatory approval in 1995, mycophenolate mofetil (MMF) has largely replaced azathioprine (AZA) as the anti-metabolite immunosuppressive of choice in kidney transplantation. While the initial industry-sponsored clinical trials suggested strong reductions in the incidence of acute rejection in the first six months post transplantation, long-term follow-up studies have failed to demonstrate a similar degree of benefit in overall graft and patient survival. In addition, several subsequent studies have raised questions on the potential attenuating effects of calcineurin inhibitor choice on MMF efficacy when compared to AZA. This review will revisit the question of whether the available evidence continues to support the superiority of MMF over AZA in kidney transplantation outcomes while comprehensively reviewing the available evidence from clinical trial data, systematic reviews, and registry studies.
ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2013.10.005