Equivalent pharmacokinetics of mycophenolate mofetil in African-American and Caucasian male and female stable renal allograft recipients

被引:59
|
作者
Pescovitz, MD [1 ]
Guasch, A
Gaston, R
Rajagopalan, P
Tomlanovich, S
Weinstein, S
Bumgardner, GL
Melton, L
Ducray, PS
Banken, L
Hall, J
Boutouyrie, BX
机构
[1] Indiana Univ, Indianapolis, IN 46204 USA
[2] Emory Univ, Atlanta, GA 30322 USA
[3] Univ Alabama, Birmingham, AL USA
[4] Med Univ S Carolina, Charleston, SC 29425 USA
[5] UCSF, San Francisco, CA USA
[6] Lifelink Transplant Inst, Tampa, FL USA
[7] Ohio State Univ, Columbus, OH 43210 USA
[8] Baylor Univ, Med Ctr, Dallas, TX USA
[9] F Hoffmann La Roche Pharma Dev, Basel, Switzerland
关键词
diabetes; gender; mycophenolate mofetil; mycophenolic acid; pharmacokinetic; race;
D O I
10.1046/j.1600-6135.2003.00243.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
African-American (AA) renal transplant recipients require higher doses of mycophenolate mofetil (MMF) than Caucasians. A hypothesized pharmacokinetic (PK) difference Was tested in stable renal transplant recipients. Whole blood was collected before, and 20,40 and 75 min, and 2,3,4,6,8 and 12 h after the MMF dose. Mycophenolic acid (MPA) and its glucuronide metabolite (MPAG) were analyzed using HPLC. Analysis of variance was performed for the primary end-points of dose-adjusted PK parameters AUC(0-12) and C-max of MPA using log-transformed values. Differences between races and genders were estimated: 90% confidence intervals (Cl) were calculated. Back-transformation gave estimates of the race and gender ratio and their Cl. Equivalence of the groups was determined if the 90% confidence limits were included in the interval (0.80, 1.25). The calculated PK parameters were comparable among the four subgroups (Caucasian, AA, Male, Female). The 90% Cls for the ratio of dose-adjusted AUC(0-12) of MPA between races were between 89.7 and 112.9%. There were no race, gender or race-by-gender effects (P-values = 0.196) nor differences between diabetics and nondiabetics. This study demonstrates that dosing requirement for MMF in AA and Caucasians is unlikely to be related to different exposures to MPA.
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页码:1581 / 1586
页数:6
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