Mycophenolate Mofetil Decreases Acute Rejection and may Improve Graft Survival in Renal Transplant Recipients When Compared with Azathioprine: A Systematic Review

@article{Knight2009MycophenolateMD,
  title={Mycophenolate Mofetil Decreases Acute Rejection and may Improve Graft Survival in Renal Transplant Recipients When Compared with Azathioprine: A Systematic Review},
  author={Simon R. Knight and Neil K. Russell and Leticia Barcena and Peter J. Morris},
  journal={Transplantation},
  year={2009},
  volume={87},
  pages={785-794}
}
Background. Mycophenolate mofetil (MMF) has increasingly replaced azathioprine (AZA) as the antimetabolite of choice in immunosuppressive protocols. Initial trials comparing MMF with AZA in patients receiving cyclosporine A sandimmune showed a clinical benefit in reducing the incidence of acute rejections. It has been questioned whether this benefit remains significant when using newer formulations of cyclosporine A (neoral) and tacrolimus. Methods. Literature searches were performed using the… 
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152 Citations

Mycophenolate mofetil versus azathioprine in kidney transplant recipients on steroid-free, low-dose cyclosporine immunosuppression (ATHENA): A pragmatic randomized trial
TLDR
It is found that in deceased donor kidney transplant recipients on low-dose CsA and no steroids, MMF had no significant benefits over AZA, suggesting thatAZA, due to its lower costs, could safely replace MMF in combination with minimized immunosuppression.
Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.
  • O. RaheemP. Daly D. Hickey
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2012
TLDR
There was no difference in acute rejection episodes between MMF and AZA based immunotherapy and there was no significant difference concerning graft survival in the MMF group when compared to AZA group.
Long-term outcome of azathioprine versus mycophenolate mofetil in cyclosporine-based immunosuppression in kidney transplantation: 10 years of experience at a single center.
mTOR inhibitor versus mycophenolic acid as the primary immunosuppression regime combined with calcineurin inhibitor for kidney transplant recipients: a meta-analysis
TLDR
mTOR-I showed no particular superiority to MPA, and had an increased risk of graft loss when combined with CNI, even when Combined with a reduced dose of CNI.
Comparison of azathioprine with mycophenolate mofetil in a living donor kidney transplant programme
TLDR
In tacrolimus-based Immunosuppression, azathioprine may be as good as MMF as maintenance immunosuppressive drug in living donor kidney transplantation and it is also a more cost-effective immunOSuppression.
Mycophenolic acid versus azathioprine as primary immunosuppression for kidney transplant recipients.
TLDR
This review of randomised controlled trials (RCTs) aimed to look at the benefits and harms of MPA versus AZA in primary immunosuppressive regimens after kidney transplantation, including their efficacy for maintaining graft and patient survival, prevention of acute rejection, maintaining graft function and their safety, including infections, malignancies and other adverse events.
Mycophenolate Mofetil Use Is Associated With Prolonged Graft Survival After Kidney Transplantation
TLDR
The data from this observational study suggest that mycophenolate mofetil use was associated with a lower risk of graft loss than azathioprine-based immunosuppression.
Differential profiles of adverse events associated with mycophenolate mofetil between adult and pediatric renal transplant patients
TLDR
The results show the safety profile of MMF in pediatric renal transplant patients and can be used to update information used for prescriptions for pediatric patients.
The impact of mycophenolate mofetil versus azathioprine as adjunctive therapy to cyclosporine on the rates of renal allograft loss due to glomerular disease recurrence
TLDR
A retrospective study based on the Organ Procurement and Transplantation Network/United Network for Organ Sharing database designed to compare the Kaplan–Meier rates of graft loss due to disease recurrence stratified by primary renal diagnoses between recipients receiving CSA + AZA versus CSA -MMF finds no statistically significant difference.
Azathioprine (AZA) or Mycophenolate in Renal Transplant Recipients?
  • C. Ponticelli
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2010
Retrospective analyses of registry data comparing the efficacy and safety of mycophenolate mofetil (MMF) and AZA in renal transplant recipients reported conflicting results. Schold and Kaplan (Am J…
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