Mycophenolic acid drug monitoring in patients with systemic sclerosis associated with diffuse skin and/or pulmonary involvement: A monocentric and retrospective French study.
PK/PD relationship
Systemic sclerosis
diffuse
interstitial lung disease
mycophenolate mofetil
Journal
Journal of scleroderma and related disorders
ISSN: 2397-1991
Titre abrégé: J Scleroderma Relat Disord
Pays: England
ID NLM: 101685427
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
02
01
2020
accepted:
24
06
2020
entrez:
6
4
2022
pubmed:
1
2
2021
medline:
1
2
2021
Statut:
ppublish
Résumé
To explore pharmacokinetic/pharmacodynamic relationship between mycophenolic acid area under the curve and clinical response at 1 year on skin involvement or interstitial lung disease in patients with systemic sclerosis. Retrospective, monocentric study based on French Scleroderma Database in patients receiving mycophenolate mofetil who experienced a limited sampling strategy to estimate individual mycophenolic acid area under the curve plus two pulmonary function tests and skin evaluation after 1 month and 1 year. Efficacy criterions were variations of modified Rodnan skin score, forced vital capacity, and diffusing lung capacity for carbon monoxide at 1 year. We included 52 patients; mean age was 49 years (range 17-79), and 36 (69%) were females. Fifty patients (96%) had skin sclerosis, 39 (75%) had diffuse skin involvement with a median modified Rodnan skin score of 14 (0-38). Thirty-eight (76%) had interstitial lung disease, with median forced vital capacity and diffusing lung capacity for carbon monoxide of 81% (37-127) and 56% (28-103) from predicted values, respectively. Twenty-five (51%) patients had pulmonary fibrosis. Mycophenolate mofetil was given for 10 months (0-173) at a median dose of 2000 mg/day (500-3000). In the entire population, no relationship was found between area under the curve and modified Rodnan skin score (p = 0.085), forced vital capacity (p = 0.80), or diffusing lung capacity for carbon monoxide (p = 0.72) variations at 1 year. In this retrospective study, we failed to document any relationship between mycophenolic acid area under the curve and skin involvement or interstitial lung disease evolution. Routine monitoring of mycophenolic acid in systemic sclerosis patients treated with mycophenolate mofetil cannot be recommended based on our results.
Identifiants
pubmed: 35382246
doi: 10.1177/2397198320944342
pii: 10.1177_2397198320944342
pmc: PMC8922638
doi:
Types de publication
Journal Article
Langues
eng
Pagination
87-95Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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