Pharmacokinetic study of mycophenolic acid in pediatric kidney transplantation

• Published in: Andes pediatrica : revista Chilena de pediatría Vol. 93; no. 2; pp. 184 - 191
• Main Authors: Boza Fuentes, Pía, Yáñez Osorio, Dominique, Espinoza Giacomozzi, Natalie, de la Rivera Morales, Alonso, Rojo Lozano, Angélica, Delucchi Bicocchi, Angela, Salas Palma, Carolina
• Format: Journal Article
• Language: Spanish
• Published: 01.04.2022
• ISSN: 2452-6053
• DOI: 10.32641/andespediatr.v93i2.3733

INTRODUCTIONMycophenolic acid (MPA) is among the drugs used to achieve effective immunosuppression in kid ney transplantation (KT), which is characterized by complex pharmacokinetics and high intra- and interindividual variability. Monitoring the trough concentration level (C0) of MPA for dosage ad justments is considered controversial, mainly due to its low correlation with the area under the curve (AUC). OBJECTIVETo correlate the C0 and AUC of MPA in pediatric patients with KT. PATIENTS AND METHODProspective study carried out in 54 KT patients under treatment with MPA. Linear regressions and correlations were performed between ABC and C0. Multiple comparisons group analysis was performed according to post-transplant time and the two oral presentations of MPA. RESULTSThe plasma level that best correlates with AUC was C0 (r2 = 0.52). There was a significant group of patients with subtherapeutic levels (36.6% of all measurements). It was also determined that the C0 must be between 1.42 and 4.55 µg/ml for the AUC to be within the therapeutic range. It was shown that the correlation between C0 and AUC improves after three months post-transplantation and is even better when administering mycophenolate mofetil. CONCLUSIONThe use of C0 is recom mended to adjust the dose of MPA in pediatric patients with KT, especially in those with more than 3 months post-transplantation. For patients with early KT or complex clinical pictures, monitoring using ABC is recommended.