Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium

Kina Jeon; Darae Kim; Jin Oh Choi; Yang Hyun Cho; Kiick Sung; Jaewon Oh; Hyun Jai Cho; Sung Ho Jung; Hae Young Lee; Jin Joo Park; Dong Ju Choi; Seok Min Kang; Jae Joong Kim; Eun Seok Jeon

doi:10.3389/fcvm.2022.957299

Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium

Kina Jeon, Darae Kim, Jin Oh Choi, Yang Hyun Cho, Kiick Sung, Jaewon Oh, Hyun Jai Cho, Sung Ho Jung, Hae Young Lee, Jin Joo Park, Dong Ju Choi, Seok Min Kang, Jae Joong Kim, Eun Seok Jeon

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated. Methods: In this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test. Results: A total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up. Conclusion: Notable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx.

Original language	English
Article number	957299
Journal	Frontiers in Cardiovascular Medicine
Volume	9
DOIs	https://doi.org/10.3389/fcvm.2022.957299
Publication status	Published - 2022 Aug 23

Bibliographical note

Funding Information:
This research was supported by a fund (2014-ER6301-00, 2014-ER6301-01, 2014-ER6301-02, 2017-ER6301-00, 2017-ER6301-01, and 2017-ER6301-02) by Research of Korea Centers for Disease Control and Prevention Agency. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
Copyright © 2022 Jeon, Kim, Choi, Cho, Sung, Oh, Cho, Jung, Lee, Park, Choi, Kang, Kim and Jeon.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.3389/fcvm.2022.957299

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Jeon, K., Kim, D., Choi, J. O., Cho, Y. H., Sung, K., Oh, J., Cho, H. J., Jung, S. H., Lee, H. Y., Park, J. J., Choi, D. J., Kang, S. M., Kim, J. J., & Jeon, E. S. (2022). Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium. Frontiers in Cardiovascular Medicine, 9, [957299]. https://doi.org/10.3389/fcvm.2022.957299

@article{c247c8cad6984646bd7c8551f97732f3,

title = "Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium",

abstract = "Background: Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated. Methods: In this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test. Results: A total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up. Conclusion: Notable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx.",

author = "Kina Jeon and Darae Kim and Choi, {Jin Oh} and Cho, {Yang Hyun} and Kiick Sung and Jaewon Oh and Cho, {Hyun Jai} and Jung, {Sung Ho} and Lee, {Hae Young} and Park, {Jin Joo} and Choi, {Dong Ju} and Kang, {Seok Min} and Kim, {Jae Joong} and Jeon, {Eun Seok}",

note = "Funding Information: This research was supported by a fund (2014-ER6301-00, 2014-ER6301-01, 2014-ER6301-02, 2017-ER6301-00, 2017-ER6301-01, and 2017-ER6301-02) by Research of Korea Centers for Disease Control and Prevention Agency. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: Copyright {\textcopyright} 2022 Jeon, Kim, Choi, Cho, Sung, Oh, Cho, Jung, Lee, Park, Choi, Kang, Kim and Jeon.",

year = "2022",

month = aug,

day = "23",

doi = "10.3389/fcvm.2022.957299",

language = "English",

volume = "9",

journal = "Frontiers in Cardiovascular Medicine",

issn = "2297-055X",

publisher = "Frontiers Media S. A.",

}

Jeon, K, Kim, D, Choi, JO, Cho, YH, Sung, K, Oh, J, Cho, HJ, Jung, SH, Lee, HY, Park, JJ, Choi, DJ, Kang, SM, Kim, JJ & Jeon, ES 2022, 'Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium', Frontiers in Cardiovascular Medicine, vol. 9, 957299. https://doi.org/10.3389/fcvm.2022.957299

TY - JOUR

T1 - Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium

AU - Jeon, Kina

AU - Kim, Darae

AU - Choi, Jin Oh

AU - Cho, Yang Hyun

AU - Sung, Kiick

AU - Oh, Jaewon

AU - Cho, Hyun Jai

AU - Jung, Sung Ho

AU - Lee, Hae Young

AU - Park, Jin Joo

AU - Choi, Dong Ju

AU - Kang, Seok Min

AU - Kim, Jae Joong

AU - Jeon, Eun Seok

N1 - Funding Information: This research was supported by a fund (2014-ER6301-00, 2014-ER6301-01, 2014-ER6301-02, 2017-ER6301-00, 2017-ER6301-01, and 2017-ER6301-02) by Research of Korea Centers for Disease Control and Prevention Agency. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: Copyright © 2022 Jeon, Kim, Choi, Cho, Sung, Oh, Cho, Jung, Lee, Park, Choi, Kang, Kim and Jeon.

PY - 2022/8/23

Y1 - 2022/8/23

N2 - Background: Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated. Methods: In this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test. Results: A total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up. Conclusion: Notable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx.

AB - Background: Mycophenolate mofetil (MMF) is a prodrug of mycophenolic acid (MPA) and a key immunosuppressant for improving graft survival in patients with heart transplantation (HTx). However, dose reduction or interruption is occasionally needed due to gastrointestinal (GI) side effects. Enteric-coated mycophenolate sodium (EC-MPS) is an alternative form of MPA delivery to improve GI tolerability. In the present study, the efficacy of EC-MPS compared with MMF in HTx patients was investigated. Methods: In this retrospective study, the Korean Organ Transplant Registry (KOTRY) data were used to analyze the efficacy and rejection rate of MMF and EC-MPS. A total of 611 patients was enrolled from 2014 to February of 2021. Patients were divided based on the use of MMF or EC-MPS at 6 months post-HTx. Patients who were not prescribed MMF or EC-MPS were excluded. Graft survival, all-cause mortality, and treated rejection were compared between the two groups. All statistical analyses were performed using SPSS; characteristics were compared using Pearson chi-square test and survival rate with Kaplan-Meier plot and log-rank test. Results: A total of 510 HTx patients was analyzed (mean age: 51.74 ± 13.16 years, males: 68.2%). At 6 months after HTx, 78 patients were taking EC-MPA (12.8%) and 432 patients were taking MMF (70.7%). The median follow-up was 42.0 months (IQR: 21.7–61.0 months). Post-HTx outcomes including overall survival, all cause mortality, acute cell mediated rejection (ACR), acute antibody mediated rejection (AMR), treated rejection, and cardiac allograft vasculopathy (CAV) were comparable between the two groups during follow-up. Conclusion: Notable differences were not observed in overall survival, all cause mortality, ACR, AMR, treated rejection, and CAV between MMF and EC-MPS groups. Efficacy of EC-MPS was similar to that of MMF in HTx patients during mid-term follow up after HTx.

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DO - 10.3389/fcvm.2022.957299

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JO - Frontiers in Cardiovascular Medicine

JF - Frontiers in Cardiovascular Medicine

M1 - 957299

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Comparison of mid-term clinical outcome in heart transplantation patients using mycophenolate mofetil vs. enteric-coated mycophenolate sodium

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