Mycophenolate mofetil: safety and efficacy in the prophylaxis of acute kidney transplantation rejection

Figures & data

Figure 1 Chemical structure of mycophenolate mofetil (MMF) – the morpholinoethyl ester of mycophenolic acid (MPA) – mycophenolate.

Figure 2 Mechanism of action – Inhibition of de novo pathway of purine synthesis by mycophenolate mofetil.

Abbreviations: HGPRT, hypoxanthine-guanine phosphoribosyl; IMPDH, inosine monophosphate dehydrogenase.

Table 1 Summary table of MMF pivotal trials

Trial	MMF group	Control group	Induction	BPAR at 6 months
US Renal Transplantation Study^Citation26	MMF/CSA/CS	AZA/CSA/CS	ATG	MMF better
European Study^Citation24	MMF/CSA/CS	Placebo/CSA/CS	No	MMF better
Tricontinental Study^Citation25	MMF/CSA/CS	AZA/CSA/CS	No	MMF better
MYSS Study^Citation28	MMF/Neoral/CS	AZA/Neoral/CS	No	No difference

Abbreviations: MMF, mycophenolate mofetil; AZA, azathioprine; CS, corticosteroids; CSA, cyclosporine; ATG, antithymocyte globulin; Neoral, microemusion cyclosporine; BPAR, biopsy proven acute rejection.

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