Controlled randomized study comparing the cardiovascular profile of everolimus with tacrolimus in renal transplantation

Autor: Joan M. Diaz, Ana Sánchez-Fructuoso, Alexandra Paravisini, Josep M. Cruzado, Manuel Rengel, Daniel Serón, Nuria Saval, Domingo Hernández, José M. Morales, Federico Oppenheimer, Julio Pascual
Rok vydání: 2016
Předmět:
Graft Rejection
Male
medicine.medical_treatment
030232 urology & nephrology
Blood Pressure
030204 cardiovascular system & hematology
Left ventricular hypertrophy
Kidney Function Tests
0302 clinical medicine
Risk Factors
Renal Insufficiency
tacrolimus
Kidney transplantation
Proteinuria
Graft Survival
Immunosuppression
Middle Aged
left ventricular hypertrophy
Female
Patient Safety
medicine.symptom
Drug Monitoring
Immunosuppressive Agents
medicine.drug
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Adolescent
Heart Ventricles
Urology
Mycophenolic acid
Tacrolimus
03 medical and health sciences
Young Adult
medicine
Humans
Everolimus
Aged
Transplantation
business.industry
Mycophenolic Acid
medicine.disease
everolimus
Kidney Transplantation
Surgery
cardiovascular profile
business
Biomarkers
Zdroj: TRANSPLANT INTERNATIONAL
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 0934-0874
Popis: Left ventricular hypertrophy (LVH) regression after kidney transplantation may be influenced by immunosuppression. In a 24-month open-label, multicenter, phase-IV study, 71 kidney allograft recipients without previous acute rejection, showing eGFR > 40 ml/min and proteinuria < 500 mg/day and between 6 months and 3 years post-transplantation, were randomized to receive everolimus (EVR) + mycophenolic acid (MPA) or were maintained on tacrolimus (TAC) + MPA. The aim was to assess whether the conversion to EVR could reduce left ventricular mass index (LVMi) at month-24. LVMi at month-24 decreased without differences between groups (TAC: 54.0 vs. 48.2 g/m(2.7); EVR: 53.4 vs. 49.4 g/m(2.7)). The LVH prevalence at baseline and month-24 was 59.4% and 40.6% in TAC group and 57.1% and 50.0% in EVR group. EVR conversion was associated with nearly disappearance of concentric LVH and concentric remodeling pattern. The procollagen type I N-terminal propeptide at month-24 showed greater reduction in EVR group (51.6 vs. 58.2 mg/l; P = 0.004). Conversion from TAC to EVR was associated with a significant improvement of eGFR (P = 0.0315, ANCOVA). Adverse events were similar between groups without rejection episode or graft loss. Conversion from TAC to EVR did not further reduce LVMi after 24 months, although its effect on concentric LVH deserves further investigation (NCT01169701).
Databáze: OpenAIRE
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