Therapeutic dose monitoring of mycophenolate mofetil in dermatologic diseases.
Background: Mycophenolate mofetil (MMF) is used for prevention of allograft rejection in transplantation medicine. In dermatology it is used as a corticosteroid-sparing agent. The pharmacokinetics of MMF are known to vary by individual. Therapeutic dose monitoring of mycophenolic acid (MPA), the act...
| Publicado en: | Journal of the American Academy of Dermatology Vol. 68; no. s1; pp. 36 - 41 |
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| Autores principales: | , , , , , |
| Formato: | case study research Journal Article |
| Publicado: |
Elsevier B.V.
Jan2013 Supplement
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104402652&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104402652 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01909622 1ZF jtl: Journal of the American Academy of Dermatology issn: 01909622 maglogo: N pubinfo: dt: Jan2013 Supplement vid: 68 iid: s1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104402652 104402652 NLM22884445 2011801789 10.1016/j.jaad.2012.07.003 NLM22884445 104402652 ppf: 36 ppct: 5 formats: tig: atl: Therapeutic dose monitoring of mycophenolate mofetil in dermatologic diseases. aug: au: Sokumbi O El-Azhary RA Langman LJ Sokumbi, Olayemi el-Azhary, Rokea A Langman, Loralie J affil: Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA sug: subj: Immunosuppressive Agents Administration and Dosage Immunosuppressive Agents Pharmacokinetics Mycophenolic Acid Mycophenolic Acid Blood Skin Diseases Drug Therapy Adult Female Human Immunosuppressive Agents Adverse Effects Male Middle Age Mycophenolic Acid Administration and Dosage Mycophenolic Acid Adverse Effects Mycophenolic Acid Pharmacokinetics Prednisone Therapeutic Use Retrospective Design Skin Diseases Blood Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Mycophenolate mofetil (MMF) is used for prevention of allograft rejection in transplantation medicine. In dermatology it is used as a corticosteroid-sparing agent. The pharmacokinetics of MMF are known to vary by individual. Therapeutic dose monitoring of mycophenolic acid (MPA), the active metabolite of MMF, is used as a guide in transplantation medicine, but limited data exist on the benefit of measuring MPA levels in the management of dermatologic disease.Objective: We sought to describe the use of MPA level monitoring in the management of dermatologic disease.Methods: We retrospectively searched for cases of patients who were treated with MMF for a dermatologic condition at our tertiary care center, and who had at least 1 trough level measurement of MPA from January 1, 2003, through November 30, 2009.Results: Our search identified 24 patients treated with MMF for autoimmune bullous diseases, connective tissue diseases, erythema multiforme, atopic dermatitis, or pyoderma gangrenosum who had at least 1 MPA trough level measured. The range of MPA levels in patients who responded to therapy was 1.2 to 8 μg/mL at a dose range of 1 to 3.5 g/d of MMF. Four cases were analyzed in detail to highlight the use of therapeutic dose monitoring in the management of dermatologic disease.Limitations: This was a retrospective study.Conclusion: We recommend monitoring MPA levels only in patients not responding to the standard 2-g/d dosage of MMF. MPA levels can help the dermatologist to increase the dose in patients who have poor absorption or to detect therapeutic noncompliance. pubtype: Academic Journal doctype: case study research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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