Therapeutic drug monitoring of mycophenolate mofetil in transplantation

Teun Van Gelder; Yann Le Meur; Leslie M. Shaw; Michael Oellerich; David DeNofrio; Curtis Holt; David W. Holt; Bruce Kaplan; Dirk Kuypers; Bruno Meiser; Burkhard Toenshoff; Richard D. Mamelok

doi:10.1097/01.ftd.0000199358.80013.bd

Therapeutic drug monitoring of mycophenolate mofetil in transplantation

Teun Van Gelder, Yann Le Meur, Leslie M. Shaw, Michael Oellerich, David DeNofrio, Curtis Holt, David W. Holt, Bruce Kaplan, Dirk Kuypers, Bruno Meiser, Burkhard Toenshoff, Richard D. Mamelok

Research output: Contribution to journal › Review article › peer-review

301 Scopus citations

Abstract

A roundtable meeting to discuss the use of therapeutic drug monitoring (TDM) to guide immunosuppression with mycophenolate mofetil was held in New York in December 2004. Existing recommendations for the initial months after transplantation were updated. After ensuring adequate levels of mycophenolic acid (MPA, the active metabolite of mycophenolate mofetil) immediately after transplantation, optimal efficacy may require only a few dose adjustments, because intrapatient variability in exposure seems low. Recommendations based on current knowledge were made for posttransplantation sampling time points and for target MPA concentrations. Algorithms for estimating MPA exposure using limited sampling strategies were presented, and a new assay for MPA discussed. It was agreed that because of interpatient variability and the influence of concomitant immunosuppressants, TDM might help optimize outcomes, especially in patients at higher risk of rejection. The value of TDM in the general transplant population will be assessed from large, ongoing, randomized studies.

Original language	English (US)
Pages (from-to)	145-154
Number of pages	10
Journal	Therapeutic Drug Monitoring
Volume	28
Issue number	2
DOIs	https://doi.org/10.1097/01.ftd.0000199358.80013.bd
State	Published - Apr 2006
Externally published	Yes

Keywords

Mycophenolate mofetil
Therapeutic drug monitoring
Transplantation

ASJC Scopus subject areas

Pharmacology
Pharmacology (medical)

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10.1097/01.ftd.0000199358.80013.bd

Cite this

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title = "Therapeutic drug monitoring of mycophenolate mofetil in transplantation",

abstract = "A roundtable meeting to discuss the use of therapeutic drug monitoring (TDM) to guide immunosuppression with mycophenolate mofetil was held in New York in December 2004. Existing recommendations for the initial months after transplantation were updated. After ensuring adequate levels of mycophenolic acid (MPA, the active metabolite of mycophenolate mofetil) immediately after transplantation, optimal efficacy may require only a few dose adjustments, because intrapatient variability in exposure seems low. Recommendations based on current knowledge were made for posttransplantation sampling time points and for target MPA concentrations. Algorithms for estimating MPA exposure using limited sampling strategies were presented, and a new assay for MPA discussed. It was agreed that because of interpatient variability and the influence of concomitant immunosuppressants, TDM might help optimize outcomes, especially in patients at higher risk of rejection. The value of TDM in the general transplant population will be assessed from large, ongoing, randomized studies.",

keywords = "Mycophenolate mofetil, Therapeutic drug monitoring, Transplantation",

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doi = "10.1097/01.ftd.0000199358.80013.bd",

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AU - Van Gelder, Teun

AU - Meur, Yann Le

AU - Shaw, Leslie M.

AU - Oellerich, Michael

AU - DeNofrio, David

AU - Holt, Curtis

AU - Holt, David W.

AU - Kaplan, Bruce

AU - Kuypers, Dirk

AU - Meiser, Bruno

AU - Toenshoff, Burkhard

AU - Mamelok, Richard D.

PY - 2006/4

Y1 - 2006/4

N2 - A roundtable meeting to discuss the use of therapeutic drug monitoring (TDM) to guide immunosuppression with mycophenolate mofetil was held in New York in December 2004. Existing recommendations for the initial months after transplantation were updated. After ensuring adequate levels of mycophenolic acid (MPA, the active metabolite of mycophenolate mofetil) immediately after transplantation, optimal efficacy may require only a few dose adjustments, because intrapatient variability in exposure seems low. Recommendations based on current knowledge were made for posttransplantation sampling time points and for target MPA concentrations. Algorithms for estimating MPA exposure using limited sampling strategies were presented, and a new assay for MPA discussed. It was agreed that because of interpatient variability and the influence of concomitant immunosuppressants, TDM might help optimize outcomes, especially in patients at higher risk of rejection. The value of TDM in the general transplant population will be assessed from large, ongoing, randomized studies.

AB - A roundtable meeting to discuss the use of therapeutic drug monitoring (TDM) to guide immunosuppression with mycophenolate mofetil was held in New York in December 2004. Existing recommendations for the initial months after transplantation were updated. After ensuring adequate levels of mycophenolic acid (MPA, the active metabolite of mycophenolate mofetil) immediately after transplantation, optimal efficacy may require only a few dose adjustments, because intrapatient variability in exposure seems low. Recommendations based on current knowledge were made for posttransplantation sampling time points and for target MPA concentrations. Algorithms for estimating MPA exposure using limited sampling strategies were presented, and a new assay for MPA discussed. It was agreed that because of interpatient variability and the influence of concomitant immunosuppressants, TDM might help optimize outcomes, especially in patients at higher risk of rejection. The value of TDM in the general transplant population will be assessed from large, ongoing, randomized studies.

KW - Mycophenolate mofetil

KW - Therapeutic drug monitoring

KW - Transplantation

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Therapeutic drug monitoring of mycophenolate mofetil in transplantation

Abstract

Keywords

ASJC Scopus subject areas

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