| ABSTRACT Objective:Mycophenolic acid (MPA) therapeutic drug monitoring (TDM) of pediatric patients from Children’s Hospital of Fudan University during November 2016 to October 2017 was analyzed to improve clinical outcomes. Methods: Concentrations of serum MPA were determined by enzyme multiplied immunoassay technique, with the Mwphar+ software applied for the pharmacokinetic curve fitting analysis and calculation of the MPA–area under the concentration time curve (MPA AUC0 12h) based on the patients’ physiological conditions. The clinical data were collected, after which the patients’ gender, disease spectrum, MPA AUC0 12h, adverse drug reactions（ADR） and outcomes were analyzed.Results:A total of 237 pediatric patients treated by MMF participated in the study, with the average age at (10.70±3.61) years. The study included 319 case times of MPA TDM, and involved 14 diseases, in which systemic lupus erythematosus making the most proportion (33.54%), followed by nephrotic syndrome (16.61%) and allogeneic organ transplantation (15.05%). Of the 319 case times of MPA TDM, 48.28% of MPA exposure AUC0–12h was 30 60 mg·h·L-1. The gastrointestinal adverse effects were the most prevalent ADR, with a rate of 13.79%. All the patients with ADR were improved or recovered. Conclusion:When using MMF treating immune system diseases in pediatric patients, close attention must be paid. The Mwphar+ software is useful for the MPA pharmacokinetic curve fitting analysis, providing more accurate MPA exposure data, so as to improve clinical outcomes and ensure medication safety. |
