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基于药代动力学的实体器官移植受者麦考酚酸酯个体化给药。

Pharmacokinetic-based Dosing Individualization of Mycophenolate Mofetil in Solid Organ Transplanted Patients.

机构信息

Institute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.

出版信息

Prague Med Rep. 2024;125(3):187-194. doi: 10.14712/23362936.2024.18.

Abstract

Mycophenolate mofetil (MMF) is an immunosuppressant drug approved for prophylaxis of transplant rejection in patients undergoing solid organ transplantation and is further employed in management of various autoimmune disorders. MMF exhibits notable pharmacokinetic inter- and intraindividual variability necessitating tailored therapeutic approaches to achieve optimal therapeutic outcomes while mitigating risks of adverse effects. The objective of this review was to summarize factors that influence the pharmacokinetics of MMF and its active metabolite mycophenolic acid in order to deduce recommendations for personalized treatment strategies. Presumed predictors were analysed in relation to each of the four pharmacokinetic phases, providing tools and targets for MMF dosing optimization amenable to clinical implementation.

摘要

霉酚酸酯(MMF)是一种免疫抑制剂药物,已获批准用于预防实体器官移植患者的移植排斥反应,并且进一步用于治疗各种自身免疫性疾病。MMF 表现出明显的药代动力学个体内和个体间变异性,因此需要量身定制治疗方法,以在降低不良反应风险的同时实现最佳治疗效果。本综述的目的是总结影响 MMF 及其活性代谢物霉酚酸药代动力学的因素,以推导出个性化治疗策略的建议。推测的预测因子与四个药代动力学阶段中的每一个相关进行分析,为 MMF 剂量优化提供工具和目标,以适应临床实施。

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