The Open Access Journal of Science and Technology

Abstract

Enteric-Coated Mycophenolate Sodium and Gastrointestinal Prophylaxis in Renal Transplant Patients

Author(s): Karen Parker ,Winifred Bryant, Connie Garris-Sutton,Fatima Rana ,and Paul Bolin

Background: The purpose of this study was to evaluate the discontinuation or reduction of gastrointestinal (GI) comedicationuseandsubjects’subsequentGIsymptomsandpsychologicalwell-beingafterconversionfrommycophenolatesodium (MMF) to enteric-coated mycophenolate sodium (EC-MPS). Study Design: Prospective, single-center, open label, longitudinal study.SettingsandParticipants:54renaltransplantsubjectswhoweresuccessfullyconvertedfromMMFtoEC-MPSpreviously duetoGIsymptoms.Intervention:SubjectswereaskedtoreduceordiscontinuetheirGIco-medicationinaprogrammedfashion overathreemonthperiod.Subjectsweresubsequentlyfollowedforoneyear.Outcomes:PatientreporteduseofGImedications, symptoms,complaints,andoverallqualityoflife. Measurements:Assessmentswereperformedusingvalidatedpatient-reported outcome instruments. Cost savings was also measured. Results: Successful discontinuation or reduction of GI co-medication was achieved in 78% patients after 30 days and maintained through day 90. No significant changes in GI symptom assessments wereobservedfrombaselinetoday30or90despitediscontinuationorreductioninGIco-medication.Twelvemonthfollowup demonstratedsustainedimprovementin91%ofthesepatients.Annualcostsavingsperpatientafterreductionordiscontinuation of GI medication were estimated to be $925-$1850 for H-2 blockers and $1861-$3722 for proton-pump inhibitors. Limitations: Resultswerebasedonasinglecenter,openlabelexperienceandreliedonpatientreporteddata.Conclusions:Thisstudysupports successful long-term minimization of GI co-medications in maintenance renal transplant patients after conversion to EC-MPS. DatasuggestthatafterconversiontoEC-MPSrenaltransplantpatientscansuccessfullyreduceordiscontinueGIco-medication whilemaintainingtheirhealth-relatedqualityoflifeandoverallwell-being.

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