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CENTRE FOR EVIDENCE IN TRANSPLANTATION (CET)
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Project 7
MMF vs Aza
Mycophenolate Mofetil (MMF) has increasingly become the anti-metabolite of choice in immunosuppressive protocols since its introduction in the early 90's, replacing azathioprine (AZA). Initial large multi-centre RCTs showed a clinical benefit in reducing the incidence of acute rejections, but without significantly improving graft survival at 1 year. More recently, work from Remuzzi and colleagues has questioned whether MMF demonstrates a significant benefit over AZA when using newer formulations of Cyclosporine (Neoral) and Tacrolimus.
This meta-analysis combines the results of 20 randomised controlled trials in renal transplant recipients in order to investigate the potential benefits of MMF versus AZA in terms of acute rejection rates, graft and patient survival, graft function and safety outcomes.
The analysis is now complete, and preliminary results were presented at this years British Transplant Society Congress in Glasgow. The full analysis has been presented at the International Transplant Society congress in Sydney in August. The work has now been published in Transplantation:
Knight SR, Russell NK, Barcena L and Morris PJ. Mycophenolate Mofetil decreases acute rejection and may improve graft survival in renal transplant recipients when compared to Azathioprine. A systematic review. Transplantation. 2009 March 27; 87(6): 785-94.
