AbdElhalim Mohamed S, Kenawy Ahmed S, Demellawy Heba H El, Azouz Amany A, Alghanem Sarah S, Al-Otaibi Torki, Gheith Osama, ElMonem Mohamed Abd, Afifi Mohammed K, Hussein Raghda R S
Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Kuwait City, Kuwait.
Department of Nephrology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
Kidney Res Clin Pract. 2020 Dec 31;39(4):479-486. doi: 10.23876/j.krcp.20.059.
The absorption rates of mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS) may be influenced by the concomitant use of omeprazole.
One hundred kidney transplant patients were recruited during their outpatient visits, including 50 on MMF and 50 on EC-MPS. At the clinic, a predose mycophenolic acid (MPA) sample (C0) was collected; subsequently, the participants received the proton-pump inhibitor omeprazole along with either MMF or EC-MPS. Two more blood samples were collected at 1.5 and 3.5 hours and used to estimate an area under the curve (AUC) from zero to 12 hours [AUC (0-12)].
The mean number of months after transplant was 92 months. The median AUC (0-12) and C0 results were 62.2 mg·h/L and 2.0 mg/L for the MMF group and 71.9 mg·h/L and 1.8 mg/L for the EC-MPS group (P = 0.160 and 0.225, respectively). Interestingly, 54% of the MMF group and 62% of the EC-MPS group showed AUCs above the target values. The correlation between MPA C0 and the predicted AUC was poor in both groups.
Omeprazole can be safely co-administered with either MMF or EC-MPS, as it did not compromise the MPA exposure. Unexpectedly, however, a high percentage of patients presented MPA AUCs exceeding the target value, highlighting the importance of periodically assessing MPA level.
霉酚酸酯（MMF）和肠溶型霉酚酸钠（EC-MPS）的吸收率可能会受到奥美拉唑同时使用的影响。
在门诊就诊期间招募了100名肾移植患者，其中50名服用MMF，50名服用EC-MPS。在诊所采集了一份霉酚酸（MPA）给药前样本（C0）；随后，参与者同时接受质子泵抑制剂奥美拉唑以及MMF或EC-MPS。在1.5小时和3.5小时又采集了两份血样，用于估算从零到12小时的曲线下面积（AUC）[AUC(0 - 12)]。
移植后的平均月数为92个月。MMF组的AUC(0 - 12)中位数和C0结果分别为62.2mg·h/L和2.0mg/L，EC-MPS组分别为71.9mg·h/L和1.8mg/L（P值分别为0.160和0.225）。有趣的是，MMF组的54%和EC-MPS组的62%的AUC高于目标值。两组中MPA C0与预测的AUC之间的相关性都很差。
奥美拉唑可以与MMF或EC-MPS安全地联合使用，因为它不会影响MPA的暴露量。然而，出乎意料的是，高比例的患者MPA AUC超过目标值，这突出了定期评估MPA水平的重要性。
