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.
引用
收藏
页码:1581 / 1586
页数:6
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