European journal of clinical pharmacology · 2026
Personalizing mycophenolate therapy: genetic determinants and practical limited sampling strategy for pediatric lupus nephritis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhang Lu, Chen Lizhi, Ye Chen, Liu Xiaohong, Huang Zhijun, Tang Kejing, Chen Pan, Jiang Xiaoyun
Аннотация
OBJECTIVE: To identify determinants of mycophenolic acid (MPA) pharmacokinetics (PK) in pediatric patients with lupus nephritis (LN), and to develop a limited sampling strategy (LSS) for estimating MPA-AUC0-12 h.
METHODS: A single-center observational study enrolled biopsy-proven LN receiving mycophenolate mofetil (MMF) at least 7 consecutive days. Univariate analysis were performed to assess associations between MPA PK parameters and demographics, genetic polymorphisms, clinical variables. LSS models for predicting MPA-AUC0-12 h were developed via multivariate stepwise regression analysis.
RESULTS: Statistically significant correlations were observed between MPA-AUC0-12 h and MMF dose, plasma albumin level, estimated glomerular filtration rate, and genetic polymorphisms in HNF1A (rs56097722) and CYP2C8 (rs1058932). CES2 (rs11075646) was significantly associated with MPA half-life (T₁/₂). Single timepoint MPA concentrations demonstrated poor predictive performance for AUC0-12 h(R2 = 0.194-0.553). The optimal LSS model was achieved with four timepoints: MPA-AUC0-12 h = 2.935 + 0.716·C0.5 + 1.305·C1.5 + 3.176·C4 + 4.705·C9 (R2 = 0.945). This model demonstrated good predictive performance (MPE = 1.84%, MAPE = 9.47%, RMSE = 12.53%). The LSS model was validated internally and externally for stability and applicability.
CONCLUSION: Reduced MPA exposure was associated with MMF doses < 20 mg·kg⁻1·day⁻1, hypoproteinemia, preserved or mildly impaired renal function, and HNF1A rs56097722 C/C or CYP2C8 rs1058932 G/G genotypes. CES2 rs11075646 C/C tended to correlate with a shorter MPA T₁/₂. The validated LSS models are recommended for estimating MPA-AUC0-12 h in pediatric LN, which are expected to simplify the therapeutic drug monitoring process.
METHODS: A single-center observational study enrolled biopsy-proven LN receiving mycophenolate mofetil (MMF) at least 7 consecutive days. Univariate analysis were performed to assess associations between MPA PK parameters and demographics, genetic polymorphisms, clinical variables. LSS models for predicting MPA-AUC0-12 h were developed via multivariate stepwise regression analysis.
RESULTS: Statistically significant correlations were observed between MPA-AUC0-12 h and MMF dose, plasma albumin level, estimated glomerular filtration rate, and genetic polymorphisms in HNF1A (rs56097722) and CYP2C8 (rs1058932). CES2 (rs11075646) was significantly associated with MPA half-life (T₁/₂). Single timepoint MPA concentrations demonstrated poor predictive performance for AUC0-12 h(R2 = 0.194-0.553). The optimal LSS model was achieved with four timepoints: MPA-AUC0-12 h = 2.935 + 0.716·C0.5 + 1.305·C1.5 + 3.176·C4 + 4.705·C9 (R2 = 0.945). This model demonstrated good predictive performance (MPE = 1.84%, MAPE = 9.47%, RMSE = 12.53%). The LSS model was validated internally and externally for stability and applicability.
CONCLUSION: Reduced MPA exposure was associated with MMF doses < 20 mg·kg⁻1·day⁻1, hypoproteinemia, preserved or mildly impaired renal function, and HNF1A rs56097722 C/C or CYP2C8 rs1058932 G/G genotypes. CES2 rs11075646 C/C tended to correlate with a shorter MPA T₁/₂. The validated LSS models are recommended for estimating MPA-AUC0-12 h in pediatric LN, which are expected to simplify the therapeutic drug monitoring process.