mycophenolic acid and its metabolites in solid organ transplant recipients

Mycophenolate mofetil (MMF), an ester prodrug of the immunosuppressant mycophenolic acid (MPA), is widely used for maintenance immunosuppressive therapy and prevention of renal allograft rejection in renal transplant recipients. MPA inhibits inosine monophosphate dehydrogenase (IMPDH), an enzyme involved in the “de novo” synthesis of purine nucleotides, thus suppressing both T-cell and B-cell proliferation. MPA shows a complex pharmacokinetics with considerable interand intrapatient by betweenand within patient variabilities associated to MPA exposure. Several factors may contribute to it. The pharmacokinetic modeling according to the population pharmacokinetic approach with the non-linear mixed effects Correspondence/Reprint request: Dr. Helena Colom, Department of Pharmacy and Pharmaceutical Technology School of Pharmacy, University of Barcelona, Avgda. Joan XXIII s/num 08028 Barcelona, Spain E-mail: [email protected] Helena Colom et al. 184 models has shown to be a powerful tool to describe the relationships between MMF doses and the MPA exposures and also to identify potential predictive patients’ demographic and clinical characteristics for dose tailoring during the post-transplant immunosuppresive treatment.