{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:40:03Z","timestamp":1763037603738,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Fundamemntal Clinical Pharma"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mycophenolate mofetil (MMF) is theoretically a treatment of choice for mucous membrane pemphigoid (MMP), due to its good long\u2010term tolerance and efficacy especially in elderly patients. However, no therapeutic monitoring is currently performed despite its large inter\u2010individual variability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to investigate the exposure\/effect relationship based on the area under the curve (AUC) or trough level of mycophenolic acid in MMP patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirteen patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a029 AUC measurements performed between February 2013 and November 2016) treated for MMP at Limoges University Hospital were evaluated using the Mucous Membrane Pemphigoid Disease Area Index score, and patients were classified as improvement (&gt;50% decrease vs. baseline) vs. stabilisation (&lt;50%) or non\u2010response (no improvement). AUC was estimated using a population pharmacokinetic model and Bayesian estimation. The association between exposure parameters, demographic variables and response group was investigated using time\u2010dependent Cox models, and an AUC threshold for \u2018improvement\u2019 was also investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An improvement was observed in approximately 70% of the patients. Only the MPA AUC<jats:sub>0\u201324\u00a0h<\/jats:sub> was retained in the multivariate analysis with a decreased risk of stabilisation\/non\u2010response per 10\u00a0mg*h\/L increase, (HR\u00a0=\u00a00.64, 95% CI\u00a0=\u00a0[0.43\u20130.94], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0038). That led to an AUC<jats:sub>0\u201324\u00a0h<\/jats:sub> threshold of 89\u00a0mg*h\/L associated with excellent performances (AUC ROC\u00a0=\u00a00.828, Sen\u00a0=\u00a075%, Spe\u00a0=\u00a0100%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion\/Conclusion<\/jats:title><jats:p>An association between MPA exposure and disease was observed. Therapeutic drug monitoring can be proposed with an AUC<jats:sub>0\u201324\u00a0h<\/jats:sub> threshold of 89\u00a0mg*h\/L. It might improve the long\u2010term response of patients to this drug with better tolerance than rituximab or cyclophosphamide.<\/jats:p><\/jats:sec>","DOI":"10.1111\/fcp.12688","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T14:39:56Z","timestamp":1619707196000},"page":"1179-1187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Towards therapeutic drug monitoring of mycophenolic acid in mucous membrane pemphigoid: A retrospective single\u2010centre study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-0695","authenticated-orcid":false,"given":"Jean\u2010Baptiste","family":"Woillard","sequence":"first","affiliation":[{"name":"INSERM U1248 IPPRITT Univ. Limoges  Limoges France"},{"name":"Department of Pharmacology and Toxicology CHU Limoges  Limoges France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safae","family":"Assikar","sequence":"additional","affiliation":[{"name":"INSERM U1248 IPPRITT Univ. Limoges  Limoges France"},{"name":"Department of Dermatology CHU Limoges National Reference Center for Bullous Diseases  Limoges France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Monchaud","sequence":"additional","affiliation":[{"name":"INSERM U1248 IPPRITT Univ. Limoges  Limoges France"},{"name":"Department of Pharmacology and Toxicology CHU Limoges  Limoges France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Am\u00e9lie","family":"Couraud","sequence":"additional","affiliation":[{"name":"Department of Dermatology CHU Limoges National Reference Center for Bullous Diseases  Limoges France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Marquet","sequence":"additional","affiliation":[{"name":"INSERM U1248 IPPRITT Univ. Limoges  Limoges France"},{"name":"Department of Pharmacology and Toxicology CHU Limoges  Limoges France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"B\u00e9dane","sequence":"additional","affiliation":[{"name":"INSERM U1248 IPPRITT Univ. 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