Does reduction in mycophenolic acid dose compromise efficacy regardless of tacrolimus exposure level? An analysis of prospective data from the Mycophenolic Renal Transplant (MORE) Registry
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Post-transplant, mycophenolic acid (MPA) dose is frequently reduced because of side effects or toxicity. However, overall MPA levels are higher in patients on tacrolimus as opposed to cyclosporine. In this prospective study of patients who were also on tacrolimus, MPA dose reduction or discontinuation was associated with a higher risk of subsequent acute rejection. The effect was seen regardless of the tacrolimus level. This suggests that lowering MPA dose still carries risk in tacrolimus-treated patients.
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