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Sponsors and Collaborators: |
University of Michigan Hoffmann-La Roche |
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Information provided by: | University of Michigan |
ClinicalTrials.gov Identifier: | NCT00227045 |
The objective of this study is to determine the extent and magnitude of the pharmacokinetic drug interaction between mycophenolate mofetil (MFF) (under Css conditions) in the presence of iron in renal transplant recipients.
A two phase pharmacokinetic study will be conducted to determine the bioavailability of MMF (under steady state, Css, conditions) in the presence of two commonly prescribed iron formulations (polysaccharide iron complex and sustained release ferrous sulfate) in renal transplant recipients. This study will evaluate valuable clinical information to help better guide the appropriate utilization of the following formulations and dosing strategies:
Condition |
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End Stage Renal Disease |
Study Type: | Observational |
Study Design: | Cross-Sectional, Defined Population, Prospective Study |
Official Title: | The Iron Ion-Mycophenolate Mofetil Chelation Complex Interaction: A Two Phase Pharmacokinetic Study in Renal Allograft Recipients at the University of Michigan Transplant Program |
Estimated Enrollment: | 20 |
Study Start Date: | October 2003 |
Following oral administration, MMF is rapidly absorbed and is presystemically hydrolyzed to its active form MPA in the liver. It is then metabolized by glucuronyl transferase to its inactive metabolite mycophenolic acid glucuronide (MPAG). MPA and MPAG also undergo a significant enterohepatic recirculation process, which is thought to contribute to the secondary peaks in the serum concentrations.
Pharmacokinetic studies in healthy volunteers have demonstrated the bioavailability to be ~94%. Previous studies have shown that many concomitantly administered medications including magnesium and aluminum containing antacids and cholestyramine, significantly impair bioavailability and decrease serum MPA AUCs from 37% and 40%, respectively.
However, of the potentially significant drug interactions involving MMF, iron may have the most clinically significant consequences. A large portion of the transplant population, particularly renal allograft recipients, experience anemia requiring iron supplementation. A single dose pharmacokinetic study conducted in seven healthy volunteers evaluated the effect of concomitant iron (delayed release preparation) administration on the absorption of MMF. This study reported a significant (89.7%) decrease in AUC among patients receiving concomitant iron and MMF. Although this study provides valuable information, it fails to address several clinically pertinent questions for transplant clinicians including:
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, Michigan | |
University of Michigan | |
Ann Arbor, Michigan, United States, 48109 |
Principal Investigator: | Jeong Park, PharmD | University of Michigan Hospital |
Study ID Numbers: | CEL305 |
Study First Received: | September 23, 2005 |
Last Updated: | April 19, 2007 |
ClinicalTrials.gov Identifier: | NCT00227045 |
Health Authority: | United States: Institutional Review Board |
Kidney Transplantation |
Renal Insufficiency Urologic Diseases Renal Insufficiency, Chronic Mycophenolate mofetil |
Kidney Failure, Chronic Kidney Diseases Iron Kidney Failure |
Immunologic Factors Physiological Effects of Drugs Immunosuppressive Agents Pharmacologic Actions |