The Efficacy And Safety Of Intensified Enteric-Coated Mycophenolate Sodium With Low Exposure Of Calcineurin Inhibitors In Chinese De Novo Kidney Transplant Recipients: A Prospective Study

Aims: The aim of this study was to investigate the efficacy and safety of a transient intensified enteric-coated mycophenolate sodium (EC-MPS) dosing regimen with low exposure of calcineurin inhibitors (CNIs) in Chinese de novo kidney transplantation. Methods: In a 6-month prospective study, a total of 97 recipients were enrolled and assigned to either an intensified EC-MPS dosing (IS) regimen or a standard EC-MPS dosing (SD) regimen. The area under the curve (AUC) of MPA was assessed at week 1 post transplant. The incidences of acute rejection, patient and graft survival, renal allograft function and adverse events were analysed. Results: The IS regimen displayed a trend of acute rejection risk reduction (IS 2.7% vs. SD 13.3%, p = 0.061) and allograft function improvement (IS 62.8 +/- 14.0 ml/min per 1.73 m(2) vs. SD 56.6 +/- 18.3 ml/min per 1.73 m(2), p = 0.084) after 6-month follow-up. MPA-AUC(0-12 h) was substantially higher in the intensified EC-MPS group than the standard EC-MPS group, though without a significant difference (71.4 +/- 41.7 vs. 53.0 +/- 27.0 mg.h/l, p = 0.107). The IS regimen did not increase the incidence of adverse effects (IS 54.1% vs. 45.0%, p = 0.39), including diarrhoea or leucopenia. Conclusions: The intensified EC-MPS dosing regimen maintaining low-dose CNIs in this study may be beneficial for Chinese adult de novo kidney transplant recipients in terms of acute rejection and allograft function and is safe within 6 months post transplant.