Better Rejection-Free Survival at Three Years in Kidney Transplant Recipients With Model-Informed Precision Dosing of Mycophenolate Mofetil
dc.rights.license | open | en_US |
dc.contributor.author | VILLENEUVE, Claire | |
dc.contributor.author | HUMEAU, Antoine | |
dc.contributor.author | MONCHAUD, Caroline | |
dc.contributor.author | LABRIFFE, Marc | |
dc.contributor.author | REROLLE, Jean-Phillipe | |
hal.structure.identifier | Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept] | |
dc.contributor.author | COUZI, Lionel | |
dc.contributor.author | WESTEEL, Pierre-François | |
dc.contributor.author | ETIENNE, Isabelle | |
dc.contributor.author | KAMAR, Nassim | |
dc.contributor.author | BÜCHLER, Mathias | |
dc.contributor.author | THIERRY, Antoine | |
dc.contributor.author | MARQUET, Pierre | |
dc.date.accessioned | 2024-10-24T14:21:54Z | |
dc.date.available | 2024-10-24T14:21:54Z | |
dc.date.issued | 2024-08 | |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/202719 | |
dc.description.abstractEn | The clinical impact of individual dose adjustment of mycophenolate mofetil is still debated, due to conflicting results from randomized clinical trials. This retrospective study aimed to compare 3-year rejection-free survival and adverse effects between adult kidney transplant recipients (KTRs) with or without mycophenolate mofetil model-informed precision dosing (MIPD). MIPD is defined here as mycophenolic acid area under the curve (AUC0–12h) estimation using a limited sampling strategy, pharmacokinetic models and Bayesian estimators; dose recommendation to reach AUC0–12h = 45 mg.h/L; using a widely used online expert system. The study, nested in two multicenter prospective cohort studies, focused on patients who received a mycophenolate drug and were followed up for 1–3 years. Mycophenolate mofetil MIPD was prescribed as per local practice, on a regular basis, when deemed necessary, or not at all. The MIPD group included 341 KTRs and the control group 392. At 3 years, rejection-free survival was respectively 91.2% and 80.6% (P < 0.001) and the cumulative incidence of rejection 5.08% vs. 12.7% per patient × year (hazard ratio = 0.49 (0.34, 0.71), P < 0.001), corresponding to a 2.5-fold reduction. Significant association with rejection-free survival was confirmed in patients at low or high risk of rejection (P = 0.017 and 0.013) and in patients on tacrolimus, but not on cyclosporine (P < 0.001 and 0.205). The mycophenolate mofetil MIPD group had significantly more adverse effects, but most occurred before the first AUC0–12h, suggesting some may be the reason why MIPD was ordered. | |
dc.language.iso | EN | en_US |
dc.rights | Attribution-NonCommercial 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/us/ | * |
dc.title.en | Better Rejection-Free Survival at Three Years in Kidney Transplant Recipients With Model-Informed Precision Dosing of Mycophenolate Mofetil | |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1002/cpt.3206 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio]/Immunologie | en_US |
dc.identifier.pubmed | 38372185 | en_US |
bordeaux.journal | Clinical Pharmacology and Therapeutics | en_US |
bordeaux.page | 351 – 362 | en_US |
bordeaux.volume | 116 | en_US |
bordeaux.hal.laboratories | ImmunoConcEpT - UMR 5164 | en_US |
bordeaux.issue | 2 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.institution | CNRS | en_US |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
hal.identifier | hal-04752344 | |
hal.version | 1 | |
hal.date.transferred | 2024-10-24T14:21:57Z | |
hal.popular | non | en_US |
hal.audience | Internationale | en_US |
hal.export | true | |
dc.rights.cc | CC BY-NC | en_US |
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