Planned Randomized Conversion From Tacrolimus to Sirolimus‐Based Immunosuppressive Regimen in De Novo Kidney Transplant Recipients

@article{Silva2013PlannedRC,
  title={Planned Randomized Conversion From Tacrolimus to Sirolimus‐Based Immunosuppressive Regimen in De Novo Kidney Transplant Recipients},
  author={Helio Tedesco Silva and Claudia Rosso Felipe and Valter Duro Garcia and Elias David Neto and M{\'a}rio Abbud Filho and F L C Contieri and Deise de Boni Monteiro de Carvalho and Jos{\'e} Osmar Medina Pestana},
  journal={American Journal of Transplantation},
  year={2013},
  volume={13}
}
Planned conversion from tacrolimus to sirolimus was evaluated in de novo kidney transplant recipients. In this multicenter, randomized, open‐label study, 297 patients were initially treated with tacrolimus, mycophenolate sodium and prednisone. Of the 283 patients reaching 3 months, 97 were converted to sirolimus (SRL), 107 were maintained on tacrolimus (TAC) and 79 were patients receiving TAC without criteria to undergo intervention at month 3 (TACex). The primary objective was to show superior… 
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45 Citations
Background Citations
13
Methods Citations
2
Results Citations
6

45 Citations

Open-Label, Randomized Study of Transition From Tacrolimus to Sirolimus Immunosuppression in Renal Allograft Recipients

It is suggested that renal function improvement at 24 months is similar for patients with early conversion to sirolimus after kidney transplantation versus those remaining on tacrolimus.

Renal function to 5 years after late conversion of kidney transplant patients to everolimus: a randomized trial

Late preemptive conversion of maintenance kidney transplant patients from CNI to everolimus may be associated with improved long-term renal function and preserves immunosuppressive efficacy.

Subclinical Lesions and Donor-Specific Antibodies in Kidney Transplant Recipients Receiving Tacrolimus-Based Immunosuppressive Regimen Followed by Early Conversion to Sirolimus

In kidney transplant recipients receiving reduced TAC exposure, subclinical inflammation lesions at 3 months were associated with IF/TA at 24 months, and conversion from TAC to SRL was associated with inferior renal function, higher incidence ofIF/TA, and trends to higher occurrence of DSA at 24 years.

Campath, calcineurin inhibitor reduction, and chronic allograft nephropathy (the 3C Study) – results of a randomized controlled clinical trial

  • R. HaynesL. Blackwell P. Friend
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2018
Compared with tacrolimus‐based therapy, sirolimus-based maintenance therapy did not improve transplant function at 18 months after conversion and was associated with significant hazards of rejection and infection.

Renal function three years after early conversion from a calcineurin inhibitor to everolimus: results from a randomized trial in kidney transplantation

Conversion from cyclosporine toEverolimus at 7 weeks post‐transplant was associated with a significant benefit in renal function at 3 years when everolimus was continued.

Safety and Efficacy Outcomes 3 Years After Switching to Belatacept From a Calcineurin Inhibitor in Kidney Transplant Recipients: Results From a Phase 2 Randomized Trial.

Switching patients from a CNI to belatacept may represent a safe approach to immunosuppression and is being further explored in an ongoing phase 3b trial.

Sirolimus-Based Immunosuppressive Regimens in Renal Transplantation: A Systemic Review.

Wound Healing Complications in Kidney Transplant Recipients Receiving Everolimus

In this cohort of de novo kidney transplant recipients receiving tacrolimus and prednisone, the use of EVR was associated with higher incidence of combined clinical and subclinical WHAE compared with MPS.

Reviewing 15 years of experience with sirolimus.

Surprisingly, there are still several areas that need further investigation to improve the risk/benefit profile of SRL in kidney transplantation, including pharmacokinetic/pharmacodynamic drug-to-drug interaction with cyclosporine (CsA) or tacrolimus (TAC), mechanisms of S RL-associated adverse reactions and combinations with other drugs such as belatacept and once-daily TAC, possibly leading to improved long-term adherence.

Influence of CYP3A4 and CYP3A5 polymorphisms on tacrolimus and sirolimus exposure in stable kidney transplant recipients

Evaluating the influence of single nucleotide polymorphisms (SNPs) on TAC and SRL dose-adjusted concentrations (C0/D) in stable kidney transplant recipients resulted in significant changes in SRL and TAC C 0/D at different times after transplantation.

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