Pharmacokinetics of free mycophenolic acid and limited sampling strategy for the estimation of area under the curve in liver transplant patients.

  title={Pharmacokinetics of free mycophenolic acid and limited sampling strategy for the estimation of area under the curve in liver transplant patients.},
  author={Zhidong Gu and Bing Chen and Yan-yan Song and Baiyong Shen and Zhecheng Zhu and Wei-Xa Zhang and Junjie Xie and Xiaxing Deng and Chenghong Peng and Qishi Fan and Hao Chen},
  journal={European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences},
  volume={47 4},
  • Zhidong Gu, Bing Chen, Hao Chen
  • Published 20 November 2012
  • Chemistry
  • European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences
Limited Sampling Strategy for Estimation of Mycophenolic Acid Exposure in Adult Chinese Heart Transplant Recipients
The results provide strong evidence for the use of LSS model other than a single time-point concentration of MPA when performing TDM, and both internal and external validations showed good applicability for four-point LSS equation.
A Systematic Review of Multiple Linear Regression-Based Limited Sampling Strategies for Mycophenolic Acid Area Under the Concentration–Time Curve Estimation
The most frequent time points for MPA determination in patients with different indications for mycophenolate mofetil (MMF) administration, and three time-point equations were the most frequent, seemed to be the most promising and should be validated in independent patient groups before introduction into clinical practice.
The Evaluation of Multiple Linear Regression–Based Limited Sampling Strategies for Mycophenolic Acid in Children with Nephrotic Syndrome
The MPA AUC in children with nephrotic syndrome was predicted the best by four time-point LSSs developed for renal transplant recipients, and none fulfilled the ±15% criteria for bias and precision probably due to very high percentage of bound MPA.
How Accurate and Precise Are Limited Sampling Strategies in Estimating Exposure to Mycophenolic Acid in People with Autoimmune Disease?
A compromise needs to be made between the predictive performance of the strategy and its clinical feasibility, and an opportunity exists to combine research efforts globally to create an open-source database for MPA (AUC, concentrations and outcomes) that can be used and prospectively evaluated.
Pharmacology and toxicology of mycophenolate in organ transplant recipients: an update
Mycophenolate is now the antimetabolite of choice in immunosuppressant regimens in transplant recipients, and the role of therapeutic drug monitoring (TDM) is still controversial and the ability of routine MPA TDM to improve long-term graft survival and patient outcomes is largely unknown.
Free mycophenolic acid determination in human plasma ultrafiltrate by a validated liquid chromatography-tandem mass spectrometry method.
To the best of the authors' knowledge this is the first liquid chromatography-tandem mass spectrometry method for free MPA monitoring using MPA-d3 that allows to measure plasma ultrafiltrate concentrations as low as 1 ng/mL.
The role of mycophenolate in the treatment of antineutrophil cytoplasmic antibody-associated vasculitis
Mycophenolate is a potent immunosuppressive agent in the therapy of AAV, non-inferior to other available drugs with comparable side effect profile, and could be a valuable alternative in cases of toxicity with life threatening side effects or intolerance to cyclophosphamide or azathioprine.
Clinical pharmacy service practice in a Chinese tertiary hospital
The working model of clinical pharmacists in a Chinese tertiary hospital is introduced, including ward rounds, consultation, stewardship of antimicrobial therapy, drug adverse reaction monitoring, therapeutic drug monitoring, clinical pharmacokinetics and pharmacogenetics, and training system.
Limited Sampling Strategy for Predicting Area Under the Concentration–Time Curve for Mycophenolic Acid in Chinese Adults Receiving Mycophenolate Mofetil and Tacrolimus Early After Renal Transplantation
In Chinese adults receiving MMF and tacrolimus early after renal transplantation, the best equation for predicting MPA-AUC0–12h is 4.5h, and the % mean prediction error, % mean absolute error, and % root mean squared prediction error for the best-fit formula are −0.2, 8.7%, and 14.2%, respectively.


Pharmacokinetics of Mycophenolic Acid and Determination of Area Under the Curve by Abbreviated Sampling Strategy in Chinese Liver Transplant Recipients
A regression model best fitted for the prediction of MPA area under the plasma concentration-time curve from 0 to 12 hours (AUC12) by abbreviated sampling strategy was developed by defining the clinical pharmacokinetics of mycophenolic acid in Chinese liver transplant recipients and showing the wide variability in MPA AUC12.
Validation of limited sampling strategy for the estimation of mycophenolic acid exposure in Chinese adult liver transplant recipients
  • Chen Hao, Chen Erzheng, L. Hongwei
  • Chemistry, Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2007
The model based on MPA pharmacokinetic parameters C1h,C2h, C6h, and C8h had the best ability to predict measured MPA‐AUC0‐12h, with the best coefficient of determination and the excellent prediction bias.
Total and free mycophenolic acid and its 7-O-glucuronide metabolite in Chinese adult renal transplant patients: pharmacokinetics and application of limited sampling strategies
The pattern of total and free MPA and MPAG plasma concentration-time curves in the cohort of patients taking lower doses of MMF was consistent with previous reports of Caucasian patients taking MMF 1 g bid, except that dose-normalized exposure of totaland free M PAG was much lower in the current study than in those of the Caucasians.
Limited sampling strategy for mycophenolic acid area under the curve.
No combination of any two sampling points resulted in significantly better correlation with AUC, but three-point estimates at C1, C2, and C6 resulted in excellent correlation between predicted AUC and AUC from the full profile when using the formula AUC = 10.
The pharmacokinetic-pharmacodynamic relationship for total and free mycophenolic Acid in pediatric renal transplant recipients: a report of the german study group on mycophenolate mofetil therapy.
Investigation of the pharmacokinetic (PK)/pharmacodynamic relationship of total and free MPA and PK values for the assessment of an individual's MPA PK parameters indicates that therapeutic drug monitoring of MPA has the potential for optimization of MMF efficacy in this patient population by steering patients away from the low values of M PA PK variables that are associated with an increased rejection risk.
Monitoring mycophenolic acid pharmacokinetic parameters in liver transplant recipients: Prediction of occurrence of leukopenia
  • Chen Hao, Ma Anwei, L. Hongwei
  • Medicine, Biology
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2008
C0h and AUC0‐12h of MPA could predict the subsequent occurrence of leukopenia, and these values may be used in routine monitoring for MMF therapy.
Pharmacokinetics of mycophenolic acid (MPA) and determinants of MPA free fraction in pediatric and adult renal transplant recipients. German Study group on Mycophenolate Mofetil Therapy in Pediatric Renal Transplant Recipients.
Comparing the pharmacokinetics of MPA and its major metabolite MPA glucuronide in pediatric renal transplant recipients receiving 600 mg MMF/m2 body surface area twice a day to those of adults on the currently recommended oral dose of 1 g of MMF once a day is compared.
Comparison of the Effects of Tacrolimus and Cyclosporine on the Pharmacokinetics of Mycophenolic Acid
CsA inhibits MPAG excretion into bile and offer an explanation for the well-known increased MPA exposure in organ transplant patients caused by conversion from CsA-to TRL-based immunosuppression.
Mycophenolic acid pharmacokinetics and related outcomes early after renal transplant.
The marked variability in mycophenolic acid/glucuronide pharmacokinetics occurring early post-transplant during the current study was greater in cyclosporin (12-18-fold) than in tacrolimus (four- to fivefold) treated patients.