Project 4

Therapeutic drug monitoring of Mycophenolate Mofetil

Since its introduction into clinical practice, mycophenolate mofetil (MMF) has been administered at a fixed-dose in the majority of centres. Recent evidence has demonstrated significant variability the blood levels of Mycophenolic acid (MPA, the active metabolite of MMF) relating to chronic disease states, serum albumin levels, renal function and concurrent immunosuppression. These observations have led to the suggestion that therapeutic drug monitoring may optimise the administration of MMF, improving clinical outcomes.

This systematic review evaluated the evidence for the optimum monitoring strategy and clinical benefit of MMF monitoring. It concluded that the current data regarding therapeutic monitoring of MMF is of limited quality. The most promising results to date come from limited sampling strategies, with benefit seen in one randomised controlled trial, although overall the current evidence in favour of monitoring is weak.

The results of this review have been published in Transplantation.

References

Knight SR and Morris PJ. Does the evidence support the use of Mycophenolate Mofetil therapeutic drug monitoring in clinical practice? A systematic review. Transplantation 2008; 85(12): 1675-1685.