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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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1434-6621
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Volume 49, Issue 7

Issues

Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus

Natalia Lampón
  • Unidad Monitorización Fármacos, Laboratorio Central, Hospital Clínico Universitario, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ María J. Tutor-Crespo
  • Unidad Monitorización Fármacos, Laboratorio Central, Hospital Clínico Universitario, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Rafael Romero / José C. Tutor
  • Unidad Monitorización Fármacos, Laboratorio Central, Hospital Clínico Universitario, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
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Published Online: 2011-05-17 | DOI: https://doi.org/10.1515/CCLM.2011.191

Abstract

Background: Recently, the use of the truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid (MPA) has been proposed for therapeutic monitoring in liver transplant recipients. The aim of our study was the evaluation of the clinical usefulness of truncated AUC0–2 in kidney transplant patients.

Methods: Plasma MPA was measured in samples taken before the morning dose of mycophenolate mofetil, and one-half and 2 h post-dose, completing 63 MPA concentration-time profiles from 40 adult kidney transplant recipients. The AUC from 0 to 12 h (AUC0–12) was calculated using the validated algorithm of Pawinski et al. The truncated AUC0–2 was calculated using the linear trapezoidal rule, and extrapolated to 0–12 h (trapezoidal extrapolated AUC0–12) as previously described.

Results: Algorithm calculated and trapezoidal extrapolated AUC0–12 values showed high correlation (r=0.995) and acceptable dispersion (ma68=0.71 μg·h/mL), median prediction error (6.6%) and median absolute prediction error (12.6%). The truncated AUC0–2 had acceptable diagnostic efficiency (87%) in the classification of subtherapeutic, therapeutic or supratherapeutic values with respect to AUC0–12. However, due to the high inter-individual variation of the drug absorption-rate, the dispersion between both pharmacokinetic variables (ma68=6.9 μg·h/mL) was unacceptable.

Conclusions: The substantial dispersion between truncated AUC0–2 and AUC0–12 values may be a serious objection for the routine use of MPA AUC0–2 in clinical practice.

Keywords: mycophenolic acid; renal transplantation; therapeutic drug monitoring; truncated area under the curve

About the article

Corresponding author: José C. Tutor, PharmD, PhD, Unidad Monitorización Fármacos, Laboratorio Central, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain Phone: +34 981 950395


Received: 2010-12-22

Accepted: 2011-02-18

Published Online: 2011-05-17

Published in Print: 2011-07-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 49, Issue 7, Pages 1167–1170, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.191.

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