calcineurin inhibitor + mycophenolic acid

CNI + mycophenolic acid is a combination immunosuppressive regimen consisting of a calcineurin inhibitor (CNI), such as tacrolimus or cyclosporine, and mycophenolic acid (MPA), available as mycophenolate mofetil or mycophenolate sodium. This regimen is a standard-of-care baseline for preventing organ rejection in transplant recipients. CNIs work by inhibiting calcineurin, a phosphatase required for the activation of the NFAT transcription factor, thereby blocking T-cell activation. Mycophenolic acid is a potent, selective, uncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), which is the rate-limiting enzyme in the de novo synthesis of guanosine nucleotides; this inhibition suppresses T- and B-lymphocyte proliferation. The combination was studied by the University of Wisconsin-Madison in a Phase 2 trial (NCT01053221) involving HLA-identical living-related kidney transplant recipients to determine if CNIs could be safely withdrawn to leave MPA monotherapy. The trial was terminated early due to a loss of funding.

Brand names

PrografCellCeptMyforticNeoralSandimmune

Other names

CNI + MPAcalcineurin inhibitor and mycophenolic acid