Reduced kidney transplant rejection rate and pharmacoeconomic advantage of mycophenolate mofetil

Wüthrich, Rudolf P.; Weinreich, T; Ambühl, Patrice M.; Schwarzkopf, Andreas; Candinas, Daniel; Binswanger, U

doi:10.1093/ndt/14.2.394

Cited by 34 publications

(17 citation statements)

References 5 publications

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“…This was associated with a higher level of CMV infections in groups 1 and 2 when compared with group 3. Our data are consistent with results obtained by other authors (13, 16–21). However, as with many other retrospective clinical studies we certainly cannot rule out confounding factors such as time since transplantation, number of kidney transplants, HLA mismatching, CMV infection rates and others.…”

Section: Discussionsupporting

confidence: 94%

Effects of mycophenolate mofetil on donor‐specific antibody formation in renal transplantation

Lederer¹,

Friedrich²,

Banas³

et al. 2005

Clinical Transplantation

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The MMF reduces anti-HLA class I and II antibody production and consequently DSA production in renal allograft recipients. Our data indicate this effect to be more pronounced in patients given MMF immediately after transplantation than in those in whom MMF is introduced some time later. The presence of DSA in the serum of renal allograft recipients is associated with poorer graft function (higher serum creatinine and more rejection episodes).

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Section: Discussionsupporting

confidence: 94%

Effects of mycophenolate mofetil on donor‐specific antibody formation in renal transplantation

Lederer¹,

Friedrich²,

Banas³

et al. 2005

Clinical Transplantation

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“…The efficacy of MMF relative to AZA for reduction of AR and LAR episodes in renal transplant recipients has been demonstrated previously (8)(9)(10)(11)(12). This study is the first to examine whether treatment with MMF or AZA differentially affects outcomes specifically in the population of diabetic renal transplant recipients.…”

Section: Discussionmentioning

confidence: 89%

Mycophenolate mofetil vs. azathioprine is associated with decreased acute rejection, late acute rejection, and risk for cardiovascular death in renal transplant recipients with pre‐transplant diabetes

David¹,

Morris²,

Steffen³

et al. 2005

Clinical Transplantation

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Outcomes specifically in mycophenolate mofetil (MMF)-treated diabetic renal transplant patients have not been previously reported. This study compared acute rejection (AR), late acute rejection (LAR), patient survival [and specifically death from cardiovascular (CV), infectious and malignant causes], incidence of post-transplant malignancies, and graft loss in MMF- or azathioprine (AZA)-treated renal transplant patients with pre-transplant diabetes. Outcomes were compared between MMF- (n = 14 144) and AZA- (n = 3001) treated diabetic patients using the Scientific Registry of Transplant Recipients data on all U.S. adult renal transplants performed between 1995 and 2002. Statistical analyses included Kaplan-Meier survival analysis, Cox multivariable regression and chi-square tests. MMF patients had less AR compared with AZA-treated patients (23.5% vs. 28.3%, p < 0.001) and less risk for LAR over 4 yr [hazard ratio (HR): 0.64, 95% CI 0.44, 0.92; p = 0.02]. While time to any-cause death did not differ between the groups, MMF treatment was associated with a 20% decreased risk of CV death (HR: 0.80, 95% CI 0.67, 0.97; p = 0.020) compared with AZA treatment. MMF patients also had a lower incidence of malignancies than AZA patients (2.2% vs. 3.7%, p < 0.001). These results suggest treatment with MMF compared with treatment with AZA in diabetic transplant patients is associated with less AR, less risk of LAR, a decreased risk of CV death, and a lower incidence of malignancies.

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“…MMF in combination with cyclosporine (CsA) and corticosteroids has been shown to decrease the incidence of ARE in adult and pediatric transplant recipients during the first 6 to 12 months after RTX by about 50% compared with placebo or azathioprine (AZA) (7)(8)(9)(10)(11)(12). Although acute rejection rates were reduced, the 1-year analysis of patient and graft survival showed no significant differences between MMF and AZA (10).…”

mentioning

confidence: 99%

Pediatric renal transplantation with mycophenolate mofetil-based immunosuppression without induction: results after three years1,2

Jungraithmayr

Staskewitz²,

Kirste³

et al. 2003

Transplantation

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Reduced kidney transplant rejection rate and pharmacoeconomic advantage of mycophenolate mofetil

Abstract: The change from AZA to MMF resulted in a significant reduction in early rejection episodes, resulting in fewer diagnostic procedures and rehospitalizations. The optimal long-term regimen in terms of patient and pharmacoeconomic benefits remains to be defined.

Cited by 34 publications

References 5 publications

Effects of mycophenolate mofetil on donor‐specific antibody formation in renal transplantation

Effects of mycophenolate mofetil on donor‐specific antibody formation in renal transplantation

Mycophenolate mofetil vs. azathioprine is associated with decreased acute rejection, late acute rejection, and risk for cardiovascular death in renal transplant recipients with pre‐transplant diabetes

Pediatric renal transplantation with mycophenolate mofetil-based immunosuppression without induction: results after three years1,2

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