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Reliability of Mycophenolic Acid Monitoring by an Enzyme Multiplied Immunoassay Technique by Delphine Martiny, Pascale Macours, Frédéric Cotton, Philippe Thiry, Béatrice Gulbis

Background: For mycophenolic acid (MPA), substantial inter- and intra-individual variability and drug interactions have been observed and therapeutic drug monitoring is now recommended. In this study, a MPA commercial Enzyme Multiplied Immunoassay Technique (EMIT) was evaluated and compared with the HPLC-UV reference method which is easily practicable in a routine laboratory.
Methods: Plasma samples (n=117) were collected from adult renal graft patients treated by mycophenolate in combination with either cyclosporin A (CyA) (n=32) or tacrolimus (n=85).
Results: Considering all samples, correlation was excellent (p<0.0001). However, significant MPA overestimation was observed with EMIT in the early post-transplant period (30 %, n=32) or when combined with cyclosporin (45 %).
Conclusions: In the early post-transplant period, or in cases where CyA is used in combination with MPA, the EMIT cannot be recommended. HPLC or LC/MS are here the method of choice.

DOI: Clin. Lab. 2010;56:345-353