Gastrointestinal side effects in liver transplant recipients taking
enteric-coated mycophenolate sodium vs. mycophenolate mofetil.
Author(s): Lopez-Solis R(1), DeVera M, Steel J, Fedorek S, Sturdevant M, Hughes C, Humar A.
Affiliation(s): Author information:
(1)Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical
Center, Pittsburgh, PA, USA.
Publication date & source: 2014, Clin Transplant. , 28(7):783-8
In the setting of liver transplantation, mycophenolate mofetil (MMF) may be used
as an adjuvant therapy for immunosuppression to prevent graft rejection; however,
its use may be limited due to severe gastrointestinal (GI) side effects. In
contrast, enteric-coated mycophenolate sodium (EC-MPS) may be associated with
less severe side effects and hence better tolerability. We compared the side
effects of EC-MPS to MMF in liver transplant patients in a de novo study (Study
I-randomized, prospective, double-blinded) and a conversion study (Study II). In
both studies, the severity of GI symptoms was assessed at various time points
using the Gastrointestinal Symptoms Rating Scale (GSRS) survey, a validated
survey of GI symptoms (abdominal pain, reflux, indigestion, diarrhea, and
constipation). In Study I, the symptoms of 30 recipients receiving EC-MPS
(n = 15) were compared to 15 recipients receiving MMF. A multivariate analysis of
variance (MANOVA) of the total GSRS scores and symptom syndrome subscores
revealed no significant difference (p > 0.05) between the two medications over
time. A conversion study (Study II) with 29 participants, however, showed that
over time, all GI symptoms improved significantly (p < 0.001) when the patients
were treated with EC-MPS instead of MMF.
|