Pastural M, Barrou B, Golmard J L, Gorichon-Radideau E, Manighetti J, Ourahma S, Benalia H, Mouquet C, Chatelain C, Bitker M O
Service d'Urologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Prog Urol. 1999 Feb;9(1):19-25.
Mycophenolate Mofetil (MMF) is a new immunosuppressant demonstrated to be effective at the dose of 2 to 3 g/day. The objective of this study was to determine whether MMF could be used at a lower dose with the same efficacy. Two patient groups were studied: 334 patients treated with azathioprine (AZA) and 60 patients treated MMF (at the dose of 750 mg/day, for patients receiving triple combination therapy or 1.5 g/day for those receiving two-agent combination therapy). The rest of the treatment was identical for the 2 groups. The main endpoint was the incidence of acute rejection at 3 months, which was 16% in the MMF group and 35% in the AZA group (p = 0.003). Multivariate analysis confirmed the impact of the type of purine synthesis inhibitor used (AZA or MMF, p = 0.007) on the acute rejection rate at 3 months. This study confirms the value of MMF, even at doses lower than those recommended in the international literature, with improved safety. MMF has now replaced azathioprine in our immunosuppressant protocols.
霉酚酸酯（MMF）是一种新型免疫抑制剂，已证明其在每日2至3克的剂量下有效。本研究的目的是确定MMF是否可以以更低的剂量使用且具有相同的疗效。研究了两个患者组：334例接受硫唑嘌呤（AZA）治疗的患者和60例接受MMF治疗的患者（对于接受三联联合治疗的患者，剂量为750毫克/天；对于接受两药联合治疗的患者，剂量为1.5克/天）。两组的其余治疗相同。主要终点是3个月时急性排斥反应的发生率，MMF组为16%，AZA组为35%（p = 0.003）。多变量分析证实了所使用的嘌呤合成抑制剂类型（AZA或MMF，p = 0.007）对3个月时急性排斥反应率的影响。本研究证实了MMF的价值，即使其剂量低于国际文献中推荐的剂量，安全性也有所提高。在我们的免疫抑制方案中，MMF现已取代了硫唑嘌呤。
