印度肾病综合征儿科患者中霉酚酸暴露情况及其临床反应
Exposure to Mycophenolic Acid and Its Clinical Response in an Indian Pediatric Population with Nephrotic Syndrome.
作者信息
Deepthi R V, Arumadi Manjusha, Eriyat Vishnu, Mathew Sumith K, Mathew Binu S, Agarwal Indira, Prabha Ratna
机构信息
Department of Pediatric Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India.
出版信息
Indian J Nephrol. 2024 Jul-Aug;34(4):323-327. doi: 10.25259/ijn_390_22. Epub 2024 May 11.
BACKGROUND
Children with nephrotic syndrome experience many side effects and frequent relapses when treated with steroids and other drugs. Mycophenolic acid (MPA) is one of the effective and least toxic drug for the treatment of nephrotic syndrome. This drug needs to be monitored for maximal efficacy and minimal toxicity. The therapeutic reference range for this drug is not established for the aforementioned patient population of Indian origin.
MATERIALS AND METHODS
In this observational study, children with nephrotic syndrome on mycophenolate mofetil were followed up for a minimum duration of three months. Following this, their clinical status (relapse/remission) was determined and the mycophenolate exposure was measured for over 12 hours.
RESULTS
A total of 34 participants were included, with 17 (50%) in relapse. Median MPA Area under the curve over 12 hours (AUC0-12h) (36.5 µg·h/ml) in the remission group differed significantly compared to that in the relapse group (17.2 µg·h/ml).
CONCLUSION
Higher exposure to MPA AUC0-12h is associated with clinical remission of pediatric nephrotic syndrome.
背景
肾病综合征患儿在使用类固醇和其他药物治疗时会出现许多副作用且频繁复发。霉酚酸（MPA）是治疗肾病综合征有效且毒性最小的药物之一。该药物需要进行监测以达到最大疗效和最小毒性。对于上述印度裔患者群体，尚未确定该药物的治疗参考范围。
材料与方法
在这项观察性研究中，对接受霉酚酸酯治疗的肾病综合征患儿进行了至少三个月的随访。在此之后，确定他们的临床状态（复发/缓解），并测量12小时以上的霉酚酸暴露量。
结果
共纳入34名参与者，其中17名（50%）复发。缓解组12小时内霉酚酸曲线下面积（AUC0-12h）中位数（36.5µg·h/ml）与复发组（17.2µg·h/ml）相比有显著差异。
结论
较高的MPA AUC0-12h暴露量与儿童肾病综合征的临床缓解相关。
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