Therapeutic drug measurement of mycophenolic acid derivatives in transplant patients

Introduction: Mycophenolic acid, the active metabolite of the prodrug mycophenolate mofetil, is widely used as an immunosuppressive agent in transplant patients for the prophylaxis of acute rejection. Recent prospective trials suggested the need for therapeutic drug monitoring, which raises the necessity to acquire accurate methods to measure MPA and its metabolites. Objective: Present an overview of the reasons to monitor MPA and its metabolites as well as a review of the currently available methods for their determination. Methods: Articles published from January 1992 to December 2006 were reviewed. Results: Most of the cited references use either chromatographic or immunoassay techniques. Basic information about biological samples used for the analysis, sample preparation, stationary phase, mobile phase, detection mode and validation data are discussed. Current information suggests the feasibility to set up method(s) to monitor MPA and its metabolites in most centers.