Mycophenolate mofetil versus enteric-coated mycophenolate sodium: a large, single-center comparison of dose adjustments and outcomes in kidney transplant recipients.

摘要: Background. Although enteric-coated mycophenolate sodium (EC-MPS) was developed to reduce gastrointestinal (GI) side effects in kidney transplantation, a multicenter clinical trial of patients undergoing de novo renal transplantation found that efficacy failure and adverse GI event rates for EC-MPS were comparable with mofetil (MMF). A common strategy mitigate mycophenolic acid-related events includes dose manipulations such as split dosing, reduction, discontinuation. Several studies have demonstrated alterations MMF are associated poorer graft outcomes. Methods. To determine whether there clinically significant difference outcomes compared MMF, we conducted retrospective study comparing all consecutive transplants (n= 1709) between 2000 2006. Results. Graft survival not different during the period (P= 0.9928). The incidence biopsy-proven acute rejection at 2 years higher group (30.2% vs. 21.9% EC-MPS, P=0.0004). adjusted risk reductions significantly MMF-treated (hazard ratio=1.703, P<0.0001). Similarly, drug discontinuation ratio= 1.507, P=0.0002). also trend toward lower infections fungal infections. Conclusion. fewer or discontinuations, which may translated into observed rejection. has become acid agent choice this large center.