Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium
BackgroundMycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coate...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.957299/full |
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| author | Kina Jeon Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon |
| author_facet | Kina Jeon Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon |
| author_sort | Kina Jeon |
| collection | DOAJ |
| description | BackgroundMycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated.MethodsIn this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test.ResultsA total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up.ConclusionNotable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx. |
| first_indexed | 2024-12-11T00:43:25Z |
| format | Article |
| id | doaj.art-d440bc811fc14c3a88851e73fdc7c0b8 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-11T00:43:25Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d440bc811fc14c3a88851e73fdc7c0b82022-12-22T01:26:50ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.957299957299Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodiumKina Jeon0Darae Kim1Jin-Oh Choi2Yang Hyun Cho3Kiick Sung4Jaewon Oh5Hyun Jai Cho6Sung-Ho Jung7Hae-Young Lee8Jin Joo Park9Dong-Ju Choi10Seok-Min Kang11Jae-Joong Kim12Eun-Seok Jeon13Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDivision of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDivision of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Thoracic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaDivision of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDivision of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDivision of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South KoreaBackgroundMycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated.MethodsIn this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test.ResultsA total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up.ConclusionNotable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx.https://www.frontiersin.org/articles/10.3389/fcvm.2022.957299/fullheart transplantationprognosismycophenolate mofetilmycophenolic acidrejection |
| spellingShingle | Kina Jeon Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium Frontiers in Cardiovascular Medicine heart transplantation prognosis mycophenolate mofetil mycophenolic acid rejection |
| title | Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium |
| title_full | Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium |
| title_fullStr | Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium |
| title_full_unstemmed | Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium |
| title_short | Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium |
| title_sort | comparison of mid term clinical outcome in heart transplantation patients using mycophenolate mofetil vs enteric coated mycophenolate sodium |
| topic | heart transplantation prognosis mycophenolate mofetil mycophenolic acid rejection |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.957299/full |
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