Gastrointestinal side effects in liver transplant recipients taking enteric‐coated mycophenolate sodium vs. mycophenolate mofetil
Identifieur interne : 004967 ( Main/Exploration ); précédent : 004966; suivant : 004968Gastrointestinal side effects in liver transplant recipients taking enteric‐coated mycophenolate sodium vs. mycophenolate mofetil
Auteurs : Roberto Lopez-Solis [États-Unis] ; Michael Devera [États-Unis] ; Jennifer Steel [États-Unis] ; Sheila Fedorek [États-Unis] ; Mark Sturdevant [États-Unis] ; Christopher Hughes [États-Unis] ; Abhinav Humar [États-Unis]Source :
- Clinical Transplantation [ 0902-0063 ] ; 2014-07.
Descripteurs français
- KwdFr :
- Acide mycophénolique (analogues et dérivés), Acide mycophénolique (effets indésirables), Acide mycophénolique (usage thérapeutique), Adolescent, Adulte, Adulte d'âge moyen, Comprimés entérosolubles, Enquêtes et questionnaires, Facteurs de risque, Femelle, Humains, Immunosuppresseurs (effets indésirables), Immunosuppresseurs (usage thérapeutique), Jeune adulte, Maladies du foie (), Maladies gastro-intestinales (), Mâle, Méthode en double aveugle, Pronostic, Qualité de vie, Receveurs de transplantation, Rejet du greffon (traitement médicamenteux), Rejet du greffon (étiologie), Sujet âgé, Sujet âgé de 80 ans ou plus, Transplantation hépatique, Études de suivi, Études prospectives.
- MESH :
- analogues et dérivés : Acide mycophénolique.
- effets indésirables : Acide mycophénolique, Immunosuppresseurs.
- traitement médicamenteux : Rejet du greffon.
- usage thérapeutique : Acide mycophénolique, Immunosuppresseurs.
- étiologie : Rejet du greffon.
- Adolescent, Adulte, Adulte d'âge moyen, Comprimés entérosolubles, Enquêtes et questionnaires, Facteurs de risque, Femelle, Humains, Jeune adulte, Maladies du foie, Maladies gastro-intestinales, Mâle, Méthode en double aveugle, Pronostic, Qualité de vie, Receveurs de transplantation, Sujet âgé, Sujet âgé de 80 ans ou plus, Transplantation hépatique, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Double-Blind Method, Female, Follow-Up Studies, Gastrointestinal Diseases (chemically induced), Graft Rejection (drug therapy), Graft Rejection (etiology), Humans, Immunosuppressive Agents (adverse effects), Immunosuppressive Agents (therapeutic use), Liver Diseases (surgery), Liver Transplantation, Male, Middle Aged, Mycophenolic Acid (adverse effects), Mycophenolic Acid (analogs & derivatives), Mycophenolic Acid (therapeutic use), Prognosis, Prospective Studies, Quality of Life, Risk Factors, Surveys and Questionnaires, Tablets, Enteric-Coated, Transplant Recipients, Young Adult.
- MESH :
- chemical , adverse effects : Immunosuppressive Agents, Mycophenolic Acid.
- chemical , analogs & derivatives : Mycophenolic Acid.
- chemically induced : Gastrointestinal Diseases.
- drug therapy : Graft Rejection.
- etiology : Graft Rejection.
- surgery : Liver Diseases.
- chemical , therapeutic use : Immunosuppressive Agents, Mycophenolic Acid.
- Adolescent, Adult, Aged, Aged, 80 and over, Double-Blind Method, Female, Follow-Up Studies, Humans, Liver Transplantation, Male, Middle Aged, Prognosis, Prospective Studies, Quality of Life, Risk Factors, Surveys and Questionnaires, Tablets, Enteric-Coated, Transplant Recipients, Young Adult.
Abstract
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.
Url:
DOI: 10.1111/ctr.12379
Affiliations:
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xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Gastrointestinal Diseases (chemically induced)</term><term>Graft Rejection (drug therapy)</term><term>Graft Rejection (etiology)</term><term>Humans</term><term>Immunosuppressive Agents (adverse effects)</term><term>Immunosuppressive Agents (therapeutic use)</term><term>Liver Diseases (surgery)</term><term>Liver Transplantation</term><term>Male</term><term>Middle Aged</term><term>Mycophenolic Acid (adverse effects)</term><term>Mycophenolic Acid (analogs & derivatives)</term><term>Mycophenolic Acid (therapeutic use)</term><term>Prognosis</term><term>Prospective Studies</term><term>Quality of Life</term><term>Risk Factors</term><term>Surveys and Questionnaires</term><term>Tablets, Enteric-Coated</term><term>Transplant Recipients</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acide mycophénolique (analogues et dérivés)</term><term>Acide mycophénolique (effets indésirables)</term><term>Acide mycophénolique (usage thérapeutique)</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Comprimés entérosolubles</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Immunosuppresseurs (effets indésirables)</term><term>Immunosuppresseurs (usage thérapeutique)</term><term>Jeune adulte</term><term>Maladies du foie ()</term><term>Maladies gastro-intestinales ()</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Pronostic</term><term>Qualité de vie</term><term>Receveurs de transplantation</term><term>Rejet du greffon (traitement médicamenteux)</term><term>Rejet du greffon (étiologie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Transplantation hépatique</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Immunosuppressive Agents</term><term>Mycophenolic Acid</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Mycophenolic Acid</term></keywords><keywords scheme="MESH" qualifier="analogues et dérivés" xml:lang="fr"><term>Acide mycophénolique</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Gastrointestinal Diseases</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Graft Rejection</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Acide mycophénolique</term><term>Immunosuppresseurs</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Graft Rejection</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Liver Diseases</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunosuppressive Agents</term><term>Mycophenolic Acid</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Acide mycophénolique</term><term>Immunosuppresseurs</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Rejet du greffon</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Liver Transplantation</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Prospective Studies</term><term>Quality of Life</term><term>Risk Factors</term><term>Surveys and Questionnaires</term><term>Tablets, Enteric-Coated</term><term>Transplant Recipients</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Comprimés entérosolubles</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Maladies du foie</term><term>Maladies gastro-intestinales</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Pronostic</term><term>Qualité de vie</term><term>Receveurs de transplantation</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Transplantation hépatique</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">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.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Lopez Olis, Roberto" sort="Lopez Olis, Roberto" uniqKey="Lopez Olis R" first="Roberto" last="Lopez-Solis">Roberto Lopez-Solis</name></region><name sortKey="Devera, Michael" sort="Devera, Michael" uniqKey="Devera M" first="Michael" last="Devera">Michael Devera</name><name sortKey="Fedorek, Sheila" sort="Fedorek, Sheila" uniqKey="Fedorek S" first="Sheila" last="Fedorek">Sheila Fedorek</name><name sortKey="Hughes, Christopher" sort="Hughes, Christopher" uniqKey="Hughes C" first="Christopher" last="Hughes">Christopher Hughes</name><name sortKey="Humar, Abhinav" sort="Humar, Abhinav" uniqKey="Humar A" first="Abhinav" last="Humar">Abhinav Humar</name><name sortKey="Lopez Olis, Roberto" sort="Lopez Olis, Roberto" uniqKey="Lopez Olis R" first="Roberto" last="Lopez-Solis">Roberto Lopez-Solis</name><name sortKey="Steel, Jennifer" sort="Steel, Jennifer" uniqKey="Steel J" first="Jennifer" last="Steel">Jennifer Steel</name><name sortKey="Sturdevant, Mark" sort="Sturdevant, Mark" uniqKey="Sturdevant M" first="Mark" last="Sturdevant">Mark Sturdevant</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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