Evidence map›Paper›PMID 33025511›Full record

ArticleDrugs in R&D2020

Population Pharmacokinetic Model of Plasma and Cellular Mycophenolic Acid in Kidney Transplant Patients from the CIMTRE Study.

François Riglet, Julie Bertrand, Aurélie Barrail-Tran, Céline Verstuyft, Hugues Michelon, Henri Benech, Antoine Durrbach, Valérie Furlan, Caroline Barau

Open access · goldAbstract read
In one paragraph

Article in Drugs in R&D, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

François RigletUniversité de Paris, INSERM, IAME, 75018, Paris, France. francois.riglet@inserm.fr.ORCID http://orcid.org/0000-0003-2696-8661
Julie BertrandUniversité de Paris, INSERM, IAME, 75018, Paris, France.
Aurélie Barrail-TranAP-HP. Université Paris-Saclay, Hôpital Bicêtre, Service de Pharmacie Clinique, Le Kremlin-Bicêtre, France.
Céline VerstuyftAP-HP, Hôpital Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France.
Hugues MichelonAP-HP. Université Paris-Saclay, Hôpital Bicêtre, Service de Pharmacie Clinique, Le Kremlin-Bicêtre, France.
Henri BenechDépartement Médicaments et technologies pour la santé, Université Paris-Saclay, CEA, INRAE, Gif-sur-Yvette, France.
Antoine DurrbachAP-HP, Hôpital Henri Mondor, Service de Néphrologie, Créteil, France.
Valérie FurlanAP-HP, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Laboratoire de Pharmacologie Toxicologie, Le Kremlin-Bicêtre, France.
Caroline BarauAP-HP, Hôpital Henri Mondor, Plateforme de Ressources Biologiques, Créteil, France.
Inserm · FRAssistance Publique – Hôpitaux de Paris · FRCommissariat à l'Énergie Atomique et aux Énergies Alternatives · FRUniversité Paris-Saclay · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveMycophenolate mofetil is widely used in kidney transplant recipients. Mycophenolate mofetil is hydrolysed by blood esterases to mycophenolic acid (MPA), the active drug. Although MPA therapeutic drug monitoring has been recommended to optimise the treatment efficacy by the area under the plasma concentration vs time curve, little is known regarding MPA concentrations in peripheral blood mononuclear cells, where MPA inhibits inosine monophosphate dehydrogenase. This study aimed to build a pharmacokinetic model using a population approach to describe MPA total and unbound concentrations in plasma and into peripheral blood mononuclear cells in 78 adult kidney transplant recipients receiving mycophenolate mofetil therapy combined with tacrolimus and prednisone.

methodsTotal and unbound plasma concentrations and peripheral blood mononuclear cell concentrations were assayed. A three-compartment model, two for plasma MPA and one for peripheral blood mononuclear cell MPA, with a zero-order absorption and a first-order elimination was used to describe the data.

resultsMycophenolic acid average concentrations in peripheral blood mononuclear cells were well above half-maximal effective concentration for inosine monophosphate dehydrogenase and no relationship was found with the occurrence of graft rejection. Three covariates affected unbound and intracellular MPA pharmacokinetics: creatinine clearance, which has an effect on unbound MPA clearance, human serum albumin, which influences fraction unbound MPA and the ABCB1 3435 C>T (rs1045642) genetic polymorphism, which has an effect on MPA efflux transport from peripheral blood mononuclear cells.

conclusionThis population pharmacokinetic model demonstrated the intracellular accumulation of MPA, the efflux of MPA out of the cells being dependent on P-glycoprotein transporters. Nevertheless, further studies are warranted to investigate the relevance of MPA concentrations in peripheral blood mononuclear cells to dosing regimen optimisation.

Indexed as

AdultAgedClinical Studies as TopicDrug MonitoringDrug Therapy, CombinationFemaleGraft RejectionHumansImmunosuppressive AgentsKidney TransplantationLeukocytes, MononuclearMaleMiddle AgedModels, BiologicalMycophenolic AcidProdrugsImmunosuppressive AgentsMycophenolic AcidProdrugsSerum Albumin

Identifiers

PMID33025511
PMCPMC7691413
OpenAlexW3092645193

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.