A pilot study on area under curve of mycophenolic acid as a guide for its optimal use in renal transplant recipients

• Published in: Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2012, Vol.135 (1), p.84-91
• Main Authors: Sarangi, S C, Reeta, K H, Agarwal, S K, Kaleekal, T, Guleria, S, Gupta, Y K
• Format: Article
• Language: English
• Subjects: Acids; Adult; Area Under Curve; Biopsy; Drug dosages; Female; Follow-Up Studies; Health aspects; Humans; Immunosuppressive agents; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Kidney Transplantation - methods; Kidneys; Male; Middle Aged; Mycophenolic Acid - administration & dosage; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - blood; Mycophenolic Acid - pharmacokinetics; Original; Patients; Pharmacokinetics; Physiological aspects; Pilot Projects; Quality of life; Sample size; Studies; Tacrolimus - adverse effects; Transplantation; Transplants & implants
• ISSN: 0971-5916
• DOI: 10.4103/0971-5916.93429

The immunosuppressants administered to renal transplant subjects are usually monitored therapeutically to prevent graft rejection and drug toxicity. Mycophenolic acid (MPA) is an immunosuppressant. The present prospective study was undertaken to establish the utility of plasma level monitoring of MPA and to correlate it with clinical outcomes in renal transplant receipients. MPA plasma level at 2, 4 and 9 h and the area under concentration-time curve (AUC) were estimated using high performance liquid chromatography in 24 renal transplant recipients receiving immunosuppressant MPA plus tacrolimus and steroid. There was wide inter-individual variation in MPA plasma level and the AUC. The incidences of gastrointestinal adverse drug events (diarrhoea and acidity) were significantly more in the high MPA AUC patients. Though biopsy proven acute rejection was not found, of the six subjects with lower MPA AUC (60 mg.h/l). The present findings suggest the MPA AUC of 30 - 60 mg.h/l in the maintenance stage of renal transplant patients to have optimum clinical benefit and relegated adverse events profile indicating the usefulness of AUC of MPA with limited sampling strategy in optimizing its use.