The impact of conversion from mycophenolate mofetil to mycophenolate sodium among renal transplant recipients on a sirolimus-based regimen.

Author(s): Kahan BD, Podbielski J, Childs B

Affiliation(s): Division of Immunology and Organ Transplantation, The University of Texas Medical School-Houston, Houston, Texas, USA.

Publication date & source: 2008-06, Transplant Proc., 40(5):1429-34.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: To examine the benefits of conversion from mycophenolate mofetil (MMF) to mycophenolic acid sodium (MPS) among renal transplant patients on sirolimus-based immunosuppression. METHODS: Alternate renal transplant recipients who were converted from MMF to MPS immediately (group A, n = 21) or 90 days thereafter (group B, n = 19) completed the Gastrointestinal Symptom Rating Scale and the Gastrointestinal Quality of Life Index (GIQLI) questionnaires at days 90 and 180. Similarly, at the completion of the study 20 members of groups A plus B (converted to MPS) and 19 patients who initially declined to participate (continuous MMF) completed the questionnaires. RESULTS: At 90 days after conversion, members of group A showed fewer responses to "feeling unwell" and to flatulence, which regressed in group B at 180 days, although more persons in the latter cohort complained of bloating. The average scores of cohort A on the GIQLI at day 180 were significantly better than those at day 90. Compared with a control cohort of continuous MMF treatment, members of cohorts A plus B showed lower incidences of diarrhea, dysphagia, and eructations but greater incidences of constipation and not feeling fit. CONCLUSION: Conversion from MMF to MPS offers subjective benefits for patients on maintenance therapy with mycophenolic acid in combination with sirolimus.