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Table 6Association of MPA outcomes with metabolites or genes

Behrend25 1997MPA, MPAG - renal function (MPA not correlation., MPAG inverse correlation., data not shown), AE/R (no association., data not shown)
Bunchman23 2001MPA, MPAG - AE/R, No associations found, but data not shown
Cantin58 2002MPA - rejection
Cattaneo18 2001MPA - rejection, kidney function; fMPA, MPA - AE
Filler73 1998MPA - diarrhea
Gajarski44 2004MPA - rejection
Gonzalez-Roncero 109 2005MPA, fMPA, MPAG, C0 and AUC - renal function: all higher in renal insufficiency than normal renal function, except MPA AUC
Johnson111 1999MPA, MPAG AUC correlation - creatine; MPA AUC correlation - albumin
Kaplan21 1999fMPA, MPAG AUC incr. in renal failure vs. function, MPA AUC same
Kuypers15 2003MPA, metabolites - AE/R, lab outcomes
Intra patient:
No association MPA, fMPA, AcMPAG, MPAG C0, Cmax, AUC - rejection, diarrhea, leukopenia
Higher AcMPAG C0, MPAG C0, AcMPAG/MPA, but not MPA in anemia (n=19) vs. not
MPA, fMPA, MPAG, AcMPAG Cmax or AUC: no difference between anemia (n=29) or leucopenia (n=12) or not
Inter-patient: No association MPA, fMPA, AcMPAG, MPAG C0, Cmax, AUC - rejection, diarrhea, leukopenia, anemia (data not shown); diarrhea, rejection not captured by AUCs, Cmax (too rare)
Correlation with GFR:
MPAG C0: r2 = -0.791
MPAG AUC: r2 = -0.709
fMPA C0: r2 = -0.791
fMPA AUC: r2 = -0.477
AcMPAG C0: r2 = -0.781
AcMPAG AUC: r2 = -0.505
MPA C0: r2 = 0.399
MPA AUC: r2= -0.039; all p<0.001
Maes16 2003MPA, metabolites. - fecal fat loss
Correlation fecal fat loss MPAG, AcMPAG, probably not MPA
Mandla R 38 2006MPA - rejection; fMPA - albumin, kidney function
Merkel U 22 2005Linear correlation. MPA C0 - creatine, MPAG C0 - creatine stronger correlation
Slight linear correlation MPA - protein, not MPAG - protein
Elevated transaminases (3 patients): MPA, MPAG concentrations similar to those without elevated transaminases
Two CMV infections: MPA, MPAG in 1st patient similar to those in patients without CMV; MPA in second (reactivated chronic) CMV patient higher than in first CMV patient
One diarrhea, no correlation to concentrations
4 rejections in 35 patients, 2 MPA concentrations in 2 acute rejections
Mogera115 1998MPA, MPAG AUC inverse correlation - GFR
Morgera116 1998MPAG AUC inverse correlation. - GFR, no difference for MPA
Naito108 2006Positive correlation MPA, MPAG C0 - creatine, stronger with CyA than Tac
Naesens79 2006MPA - liver and renal function, genes; genes - AE/R (diarrhea)
Pawinski64 2006MPA - rejection (ROC), renal function
Satoh30 2006MPA - rejection, genes; genes - AE/R (diarrhea)
Shaw20 2000MPA, fMPA, MPAG - diarrhea, renal function
No association MPA, fMPA, MPAG - diarrhea
MPAG, not MPA C0 higher in IRF
Shaw113 1998free fraction, MPAG, creatinine decrease with time, MPA increases but cannot be modeled
Sumethku32 2005MPA - AE/R
Tsaroucha24 2000MPA, MPAG - rejection (no correlation)
Weber110 1999fMPA, MPAG AUC - GFR (inverse correlation), MPA AUC increases with time, fMPA, MPAG AUCs consistent
Weber112 1998fMPA, MPAG, not MPA inverse correlation with GFR

Abbreviations: AcMPAG=Acyl Glucuronide Metabolite of Mycophenolic Acid, AE=Adverse Events, AE/R=Adverse/Rejection, AUC=Area-under-the-concentration-time curve, C0=Predose Trough Serum or Plasma Concentration, Cmax=Maximum Serum or Plasma Concentration, CMV=Cytomegalovirus, CyA=Cyclosporine, fMPA=Free Mycophenolic Acid, GFR=Glomerular Filtration Rate, IRF=Impaired Renal Function, MPA=Mycophenolic Acid, MPAG=Mycophenolic Acid Glucuronide, ROC= Receiver Operating Characteristic, TAC=Tacrolimus

From: 3, Results

Cover of Utility of Monitoring Mycophenolic Acid in Solid Organ Transplant Patients
Utility of Monitoring Mycophenolic Acid in Solid Organ Transplant Patients.
Evidence Reports/Technology Assessments, No. 164.
Oremus M, Zeidler J, Ensom MHH, et al.

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