School of Medicine, The University of Queensland, Brisbane, QLD, 4006, Australia.
School of Pharmacy, The University of Queensland, Brisbane, QLD, 4006, Australia.
Clin Drug Investig. 2019 Dec;39(12):1175-1184. doi: 10.1007/s40261-019-00844-y.
Mycophenolic acid (MPA) is commonly used following renal transplant. Saliva MPA concentrations may reflect the pharmacologically active form of MPA in plasma. Therapeutic drug monitoring using saliva is convenient and non-invasive. This study examined the correlation between total and free plasma and saliva MPA concentrations following enteric-coated mycophenolate sodium (EC-MS) administration in renal transplant recipients.
Total and free plasma and saliva MPA concentrations were measured simultaneously in 20 adult renal transplant recipients 1-2 months' post-transplant. Thirteen samples were taken pre-dose and at specified time points up until 12 h post-dose.
When considering all time points, correlation between total plasma and saliva MPA was r = 0.51 and between free plasma and saliva MPA concentrations r = 0.41. The correlation between total plasma MPA area under the concentration-time curve (AUC) or free plasma AUC and saliva MPA AUC was r = 0.25 and r = 0.13, respectively. The correlation between total plasma MPA AUC and total plasma MPA trough (C) concentrations was r = 0.51, and between total plasma MPA AUC and saliva MPA trough concentrations, r = 0.03.
Measurement of MPA concentration in saliva cannot currently replace plasma measurement for therapeutic drug monitoring of MPA following EC-MS administration. Additional studies are required to examine the relationship between MPA saliva concentrations and patient outcomes.
麦考酚酸（MPA）常用于肾移植后。唾液 MPA 浓度可能反映了血浆中 MPA 的药效形式。唾液治疗药物监测既方便又无创。本研究考察了肾移植受者服用肠溶性麦考酚钠（EC-MS）后，总血浆和游离血浆与唾液 MPA 浓度之间的相关性。
在移植后 1-2 个月，对 20 名成年肾移植受者同时进行总血浆和游离血浆与唾液 MPA 浓度的同步测量。在给药前和指定的时间点共采集了 13 个样本，直至给药后 12 小时。
考虑所有时间点，总血浆与唾液 MPA 之间的相关性为 r=0.51，游离血浆与唾液 MPA 浓度之间的相关性为 r=0.41。总血浆 MPA 浓度-时间曲线下面积（AUC）或游离血浆 AUC 与唾液 MPA AUC 之间的相关性分别为 r=0.25 和 r=0.13。总血浆 MPA AUC 与总血浆 MPA 谷浓度（C）之间的相关性为 r=0.51，总血浆 MPA AUC 与唾液 MPA 谷浓度之间的相关性为 r=0.03。
目前，唾液 MPA 浓度的测量不能替代 EC-MS 给药后对 MPA 的治疗药物监测中的血浆测量。需要进一步研究以探讨 MPA 唾液浓度与患者结局之间的关系。
