To TDM or not to TDM in lupus nephritis patients treated with MMF?

Teun Gelder, JHM Berden, Stefan Berger

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26 Citations (Scopus)


In this review, we discuss the large variability between patients in drug exposure to MPA and the evidence for a relationship between drug exposure and efficacy in lupus nephritis. Methods for drug monitoring of MPA are discussed, and based on the current literature, we suggest as potential target levels a pre-dose level of 3.0 mg/L and an area under the concentration-versus-time curve between 35 and 45 mg h/L. Therapeutic drug monitoring may improve response rates in lupus nephritis by preventing low exposure and at the same time may reduce unnecessary side effects in patients who have high drug exposure with standard dose MPA. We specifically advise assessment of MPA drug exposure early after start of treatment and before concluding that treatment with MPA has failed.
Original languageUndefined/Unknown
Pages (from-to)560-564
Number of pages5
JournalNephrology Dialysis Transplantation
Issue number4
Publication statusPublished - 2015

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