Nefrología Latinoamericana (Jan 2023)

Low adherence to mycophenolic acid in patients with lupus nephritis: assessment using the 4-item Morisky Medication Adherence Scale and plasma levels

  • Florencia Oricchio,
  • Pia González,
  • Cecilia Tessore,
  • Cecilia Ghelfi,
  • Cecilia Maldonado,
  • Marta Vázquez,
  • Óscar Noboa,
  • Gabriela Ottati,
  • Leonella Luzardo

DOI
https://doi.org/10.24875/NEFRO.22000038
Journal volume & issue
Vol. 20, no. 1

Abstract

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Introduction: Low adherence to mycophenolic acid (MPA) in patients with lupus nephritis (LN): Assessment using the 4-item Morisky Medication Adherence Scale and plasma levels. Lack of adherence among patients with chronic diseases is a growing concern for physicians. Objective: The objective of this study was to assess adherence to treatment with MPA in stable patients with LN. Materials and methods: Prospective observational monocentric study in outpatients with histologically confirmed LN under MPA treatment. We applied the 4-item Morisky Medication Adherence Scale and determined plasma concentrations of MPA. Results: Twenty-seven patients were analyzed. The results of the questionnaire determined that 70% of patients were non-adherent. The employment status, duration of lupus disease, and MPA treatment showed significant differences between adherent and non-adherent patients. Forty-five percentage of the patients showed a pre-dose concentration below 3.0 mg/L. Conclusion: To avoid unnecessary diagnostic and therapeutic interventions, non-adherence must be considered a cause of therapeutic failure in LN patients. Further studies are needed to demonstrate that therapeutic drug monitoring in LN patients would be of value in routine clinical practice.

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