Research Awards Recipients

Lay Abstract

Kidney transplant recipients need to take multiple anti-rejection medications to ensure their body does not reject the transplanted organ. Mycophenolate and prednisone are frequently prescribed together, although prednisone (a steroid) is often tapered off (i.e., dose-reduced) to prevent the development of side effects. It has been suspected that reducing the dosage of prednisone can slow down the ability of the body to remove mycophenolate, potentially leading to the accumulation and the development of mycophenolate side effects. Unfortunately, the side effects of mycophenolate are often very severe and can lead to significant patient discomfort and sometimes even death. The exact reasons behind the effects of prednisone are not clear and how much influence prednisone has on mycophenolate remains to be studied. We will measure plasma levels of mycophenolate and its broken-down products (i.e., metabolites) in patients who are taking prednisone compared to patients who are prednisone-free (i.e., not prescribed prednisone). The effects of reducing prednisone dosage on mycophenolate plasma levels will also be determined. Using state-of-the art methodologies, we will determine which patients are more likely to experience the bad effects of prednisone avoidance or dose-reduction and build a mathematical model to help clinicians adjust the dosage of mycophenolate to reduce the bad outcomes. In addition, we will also confirm, for the first time in patients, the reason (i.e., mechanism) behind the prednisone-mycophenolate drug interaction. We believe our experiments will help the transplant team better manage the patients' mycophenolate regimens. Our ultimate goal is to improve our patients' quality of lives.