Vogt B, Antoniadis A, Klinger M, Vitko S
Division of Nephrology and Hypertension, Inselspital, University of Berne, Berne, Switzerland.
Transplant Proc. 2006 Jun;38(5):1301-6. doi: 10.1016/j.transproceed.2006.02.125.
Enteric-coated mycophenolate sodium (EC-MPS) has been developed as an alternative formulation of mycophenolate acid aiming for improved gastrointestinal (GI) tolerability. This 12-month, open-label, multicenter, prospective study investigated the efficacy and tolerability of EC-MPS (720 mg twice a day) given in combination with cyclosporine microemulsion (CsA-ME) in de novo renal transplant recipients (n=140). The efficacy evaluation was the incidence of treatment failure (defined as biopsy-proven acute rejection [BPAR], graft loss, or death) after 6 and 12 months of treatment. The incidences of treatment failure, BPAR, and graft loss were comparable at 6 and 12 months (18.6% vs 22.1%, 15.7% vs 19.3%, and 1.4% vs 2.1%, respectively). Renal function at 6 and 12 months (creatinine clearance) was 60.6+/-19.8 mL/min and 63.2+/-27.1 mL/min, respectively. EC-MPS was generally well tolerated; 95.9% of the reported GI adverse events (AEs) were rated as mild or moderate. The rate of EC-MPS dose reduction was 26.4%; 4.3% were due to GI AEs. The rate of EC-MPS dose interruption was 10%; 2.1% were due to GI AEs. In summary, EC-MPS given in combination with CsA-ME demonstrates good efficacy and tolerability in de novo renal transplant recipients.
肠溶衣麦考酚钠(EC-MPS)已被开发为麦考酚酸的一种替代制剂,旨在提高胃肠道(GI)耐受性。这项为期12个月的开放标签、多中心前瞻性研究,调查了EC-MPS(每日两次,每次720毫克)联合环孢素微乳剂(CsA-ME)用于初发肾移植受者(n = 140)的疗效和耐受性。疗效评估指标为治疗6个月和12个月后治疗失败(定义为经活检证实的急性排斥反应[BPAR]、移植肾丢失或死亡)的发生率。治疗失败、BPAR和移植肾丢失的发生率在6个月和12个月时相当(分别为18.6%对22.1%、15.7%对19.3%、1.4%对2.1%)。6个月和12个月时的肾功能(肌酐清除率)分别为60.6±19.8毫升/分钟和63.2±27.1毫升/分钟。EC-MPS总体耐受性良好;报告的胃肠道不良事件(AE)中95.9%被评为轻度或中度。EC-MPS剂量降低率为26.4%;4.3%是由于胃肠道AE。EC-MPS剂量中断率为10%;2.1%是由于胃肠道AE。总之,EC-MPS联合CsA-ME在初发肾移植受者中显示出良好的疗效和耐受性。