We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Do Asian renal transplant patients need another mycophenolate mofetil dose compared with Caucasian or African American patients?
- Authors
Li, Pengmei; Shuker, Nauras; Hesselink, Dennis A.; van Schaik, Ron H. N.; Xianglin Zhang; van Gelder, Teun
- Abstract
Mycophenolate mofetil (MMF) is used to prevent acute rejection following solid organ transplantation in transplant centers all over the world. Patients from different ethnic backgrounds are treated with this drug, for which therapeutic drug monitoring (TDM) has not become the standard of practice in most centers. Whether or not some ethnic groups require a different MMF dose has been a topic of debate in recent years. In this review, it is shown that Asian patients, compared with Caucasian patients, with a comparable MMF dose reach higher mycophenolic acid (MPA) exposure. Also clinical experience points toward more adverse events in case of treatment with 1 g MMF bid in Asian patients, and therefore, for this ethnic group, a lower maintenance dose seems justified. In contrast, African American patients reach similar drug concentrations as Caucasians patients receiving the same MMF dose, but due to immunological reasons, they require a higher MMF dose to reach comparable acute rejection incidences. When TDM is performed, clinicians can correct the dose and compensate for interethnic differences in drug exposure. Otherwise, it is important to choose the right dose. This optimal dose is 20-46% lower in Asian transplant recipients than in Caucasian or African American patients.
- Subjects
MYCOPHENOLIC acid; KIDNEY transplant patients; DRUG dosage; ASIANS; DISEASES in African Americans; DISEASES
- Publication
Transplant International, 2014, Vol 27, Issue 10, p994
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12382