12-month follow-up analysis of a multicenter, randomized, prospective trial in de novo liver transplant recipients (LIS2T) comparing cyclosporine microemulsion (C2 monitoring) and tacrolimus
| Autor: | Roberto Merenda, Rudolf Steininger, M. L. Zanotelli, Ferdinand Mühlbacher, F. Oike, F. Sanjuan, Gustaf Herlenius, I. Brekke, G. Clemente, Les Lilly, A. Bernardos, Pasquale Berloco, C. Moench, Nassim Kamar, R. Maar, Umberto Cillo, André Roy, Paul Marotta, I. Cirera, K. M. Boberg, Pierre-Henri Bernard, V. Descalsi, S. Friman, A. Risaliti, Frederico Villamil, William Wall, J. Hodgson, John R Lake, Sérgio Mies, Davide F. D'Amico, Adrián Gadano, M. Yoshida, David Mayer, Christian Ducerf, Stephen Pollard, Martín Prieto, M. O'Rourke, Abhinav Humar, Daniel Cherqui, Guido Cantisani, Zakiyah Kadry, Goran B. Klintmalm, Denis Marleau, M. Cantarovich, Fernando Sanjuán, Peter W Angus, D. Neau-Cransac, Lionel Rostaing, B. Chester, John S Bynon, K. Mouette, G. Varotti, A. Villamil, R. Y. Chensu, B. D. Guardia, C. Scudamore, Faouzi Saliba, Massimo Rossi, V. Cuervas, A. Maffei-Faccioli, Stephen Munn, Youmin Wu, Gian Luca Grazi, Christophe Duvoux, J. Tchervenkov, Stephen V. Lynch, Glenda A. Balderson, Pierre-Alain Clavien, Edward Gane, Gerd Otto, J. Davidson, Gary A. Levy, P. Hayes, M. Salcedo, C. Manzarbeita, Ilka de Fátima Santana Ferreira Boin, Olivier Boillot, Jean Gugenheim, Filomena Conti, B. de Hemptinne, K. Peltekian, K. Tanaka, R. H. Weisner, Giorgio Enrico Gerunda, Y. Wu, B. Ericson, Robert M Jones, Luiz Sergio Leonardi, H. Gjertsen, I. Garcia, Jorge Ortiz, Didier Samuel, J. M. Moreno, U. Baccarani, Roberto Troisi, A. Myx, P. Aiden McCormick, G. Jeffreys, Yvon Calmus, Gary L. Davis, Antoni Rimola, R. Mennon |
|---|---|
| Přispěvatelé: | Levy G, Grazi GL, Sanjuan F, Wu Y, Muhlbacher F, Samuel D, Friman S, Jones R, Cantisani G, Villamil F, Cillo U, Clavien PA, Klintmalm G, Otto G, Pollard S, McCormick PA. |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Graft Rejection
Male Time Factors medicine.medical_treatment TACROLIMUS Azathioprine Hepacivirus HEPATITIS-C Liver transplantation medicine.disease_cause Gastroenterology chemistry.chemical_compound Living Donors Longitudinal Studies C-2 IMMUNOSUPPRESSION HEPATITIS-C DIABETES-MELLITUS C-2 REPLICATION RECURRENCE SURVIVAL Graft Survival Hepatitis C Treatment Outcome surgical procedures operative Creatinine SURVIVAL Emulsions Female Steroids Immunosuppressive Agents medicine.drug medicine.medical_specialty Hepatitis C virus Renal function RANDOMIZED STUDY Age Distribution Internal medicine medicine Diabetes Mellitus Humans Hypoglycemic Agents RECURRENCE Monitoring Physiologic Hepatitis Transplantation Hepatology business.industry LIVER TRANSPLANTATION DIABETES-MELLITUS medicine.disease Survival Analysis Tacrolimus Surgery chemistry REPLICATION CYCLOSPORINE business Follow-Up Studies |
| Popis: | The LIS2T study was an open-label, multicenter study in which recipients of a primary liver transplant were randomized to cyclosporine microemulsion (CsA-ME) (Neoral) (n = 250) (monitoring of blood concentration at 2 hours postdose) C2 or tacrolimus (n = 245) (monitoring of trough drug blood level [predose]) C0 to compare efficacy and safety at 3 and 6 months and to evaluate patient status at 12 months. All patients received steroids with or without azathioprine. At 12 months, 85% of CsA-ME patients and 86% of tacrolimus patients survived with a functioning graft (P not significant). Efficacy was similar in deceased- and living-donor recipients. Significantly fewer hepatitis C–positive patients died or lost their graft by 12 months with CsA-ME (5/88, 6%) than with tacrolimus (14/85, 16%) (P < 0.03). Recurrence of hepatitis C virus in liver grafts was similar in each group. Based on biopsies driven by clinical events, the mean time to histological diagnosis of hepatitis C virus recurrence was significantly longer with CsA-ME (100 ± 50 days) than with tacrolimus (70 ± 40 days) (P < 0.05). Median serum creatinine at 12 months was 106 μmol/L with CsA-ME and with tacrolimus. More patients who were nondiabetic at baseline received antihyperglycemic therapy in the tacrolimus group at 12 months (13% vs. 5%, P < 0.01). Of patients who were diabetic at baseline, more tacrolimus-treated individuals required anti-diabetic treatment at 12 months (70% vs. 49%, P = 0.02). Treatment for de novo or preexisting hypertension or hyperlipidemia was similar in both groups. In conclusion, the efficacy of CsA-ME monitored by blood concentration at 2 hours postdose and tacrolimus in liver transplant patients is equivalent to 12 months, and renal function is similar. More patients required antidiabetic therapy with tacrolimus regardless of diabetic status at baseline. Liver Transpl 12:1464–1472, 2006. © 2006 AASLD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|