Tacrolimus combined with two different dosages of sirolimus in kidney transplantation: Results of a multicenter study
| Autor: | D. Donati, Lars Bäckman, Y. Vanrenterghem, Martin F. Kessler, Lauri Kyllönen, J. Sánchez-Plumed, Zbigniew Wlodarczyk, Raimund Margreiter, Stefan Vitko, Paolo Rigotti, Daniel Abramowicz, Richard Rodger, Ferenc Perner, Z Czajkowski, Lionel Rostaing, B. Jaques |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Dose Biopsy 030232 urology & nephrology chemical and pharmacologic phenomena 030230 surgery Gastroenterology Tacrolimus 03 medical and health sciences 0302 clinical medicine stomatognathic system Internal medicine medicine Immunology and Allergy Humans Pharmacology (medical) Survival rate Kidney transplantation Antibacterial agent Sirolimus Transplantation Dose-Response Relationship Drug business.industry Incidence Australia Middle Aged medicine.disease Kidney Transplantation 3. Good health Surgery Calcineurin Europe Survival Rate stomatognathic diseases Regimen surgical procedures operative Treatment Outcome Drug Therapy Combination Female business Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Popis: | Tacrolimus combined with mycophenolate mofetil (MMF) is an effective regimen in kidney transplantation. This study compared the efficacy of combining tacrolimus and two different dosages of sirolimus with an established tacrolimus-MMF regimen. Each day in addition to tacrolimus, 325 patients received 2 mg sirolimus (TAC-SRL2 mg), 325 patients received 0.5 mg sirolimus (TAC-SRL0.5 mg) and 327 patients 1 g MMF (TAC-MMF). The initial tacrolimus dose was 0.2 mg/kg/day. Sirolimus patients received loading doses of 6 or 1.5 mg, and daily doses of 2 or 0.5 mg thereafter. Steroid administration was identical for all groups. The incidence of biopsy-proven acute rejection was lower in the TAC-SRL2 mg group (15.7%) compared with the TAC-SRL0.5 mg (25.2%, p = 0.003) and the TAC-MMF groups (22.3%, p = 0.036). Six-month graft survival was 91.0% (TAC-SRL2 mg), 92.6% (TAC-SRL0.5 mg) and 92.4% (TAC-MMF); the respective values for patient survival were 98.1%, 97.8% and 97.9%. Thirty-four patients (10.5%), 19 patients (5.8%) and 16 patients (4.9%) in the TAC-SRL2 mg, TAC-SRL0.5 mg and TAC-MMF groups, respectively, discontinued the study because of adverse events. Hyperlipemia was reported more often in the TAC-SRL2 mg group (24.0%) compared with 19.4% (TAC-SRL0.5 mg) and 11.0% (TAC-MMF; p < 0.05). Combining 2 mg sirolimus/day with tacrolimus results in lower rates of acute rejection, but a higher incidence of adverse events. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|