Tolerance to maintenance therapy with MMF drugs in patients after kidney transplantation with gastro-intestinal adverse effects
Abstract
The aim of the study was to evaluate the severity of gastrointestinal adverse effects (GAE) and GAE-related quality of life in stable kidney transplant recipients following their conversion from MMF therapy to enteric-coated micophenolate sodium - Myfortic (EC-MPS) administered at an equimolar dose. The prospective study of 30 kidney graft recipients in maintenance immunosuppressive therapy with MMF, cyclosporine and prednisone was performed. All patients completed the Gastrointestinal Symptom Rating Scale (GSRS; higher score indicates increased severity) and Gastrointestinal Quality of Life Index (GIQLI; higher score indicates better GI-specific health-related QoL). Apart from these, long-time changes in gastrointestinal symptoms and in quality of life following the MMF-to-EC-MPS conversion were evaluated with respective questionnaire at Visits 2 and 3. Before conversion, 93% of patients studied had gastrointestinal disturbances. Analyses of gastrointestinal symptoms intensity changes (GSRS) revealed statistically significant improvements on all subscales: abdominal pain (-1,38; p < 0,001), reflux (-1,06; p = 0,00005), diarrhea (-1,8; p = 0,00026), and dyspepsia (-1,0; p < 0,000001). The GAE-related quality of life also improved significantly: from 82,3 ± 17,5 points (at week 1 of observation) to 108,6 ± 15,5 points at 12 weeks (p = 0,00013). By the end of this study, 63% of patients appraised an improvement in their condition as stable and significant. So the conversion of kidney graft recipients from MMF to EC-MPS resulted in a significant reduction of severity of GAE and in better quality of life.
About the Authors
E. S. Stoliarevich
ФГУ НИИ трансплантологии и искусственных органов Росздрава, г. Москва
Russian Federation
Russian Federation
R. N. Vedernikova
ФГУ НИИ трансплантологии и искусственных органов Росздрава, г. Москва
Russian Federation
Russian Federation
N. A. Tomilina
ФГУ НИИ трансплантологии и искусственных органов Росздрава, г. Москва
Russian Federation
Russian Federation
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Review
For citations:
Stoliarevich E.S., Vedernikova R.N., Tomilina N.A. Tolerance to maintenance therapy with MMF drugs in patients after kidney transplantation with gastro-intestinal adverse effects. Nephrology and Dialysis. 2007;9(2):180-185. (In Russ.)
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