Long-Term Effects of the Replacement of Calcineurin Inhibitors With Everolimus and Mycophenolate in Patients With Calcineurin Inhibitor-Related Nephrotoxicity.
Adult
Calcineurin Inhibitors
/ adverse effects
Drug Substitution
Everolimus
/ therapeutic use
Female
Glomerular Filtration Rate
Heart Transplantation
Humans
Immunosuppressive Agents
/ therapeutic use
Male
Middle Aged
Mycophenolic Acid
/ therapeutic use
Postoperative Complications
/ chemically induced
Renal Insufficiency
/ chemically induced
Treatment Outcome
Journal
Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
21
12
2019
accepted:
10
01
2020
pubmed:
3
3
2020
medline:
17
9
2020
entrez:
2
3
2020
Statut:
ppublish
Résumé
There is little evidence on the long-term effects of calcineurin inhibitor (CNI) withdrawal and substitution with everolimus and mycophenolate mofetil in maintenance therapy of patients who have received heart transplants and have concurrent CNI nephrotoxicity. Aims of this study were to evaluate the progression of renal dysfunction after discontinuation of CNIs and to monitor for major adverse events after therapy change. Data from 41 patients who underwent heart transplant and have different degrees of renal dysfunction (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m In 52% of patients, there was a clear improvement in renal function (10.5 mL/min/1.73 m A therapeutic switch from CNIs to everolimus and mycophenolate mofetil can improve renal function in patients with CNI nephrotoxicity, especially in those with a shorter time period from transplantation, without exposing them to a higher incidence of late acute rejection and cardiac allograft vasculopathy.
Sections du résumé
BACKGROUND
BACKGROUND
There is little evidence on the long-term effects of calcineurin inhibitor (CNI) withdrawal and substitution with everolimus and mycophenolate mofetil in maintenance therapy of patients who have received heart transplants and have concurrent CNI nephrotoxicity. Aims of this study were to evaluate the progression of renal dysfunction after discontinuation of CNIs and to monitor for major adverse events after therapy change.
METHODS
METHODS
Data from 41 patients who underwent heart transplant and have different degrees of renal dysfunction (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m
RESULTS
RESULTS
In 52% of patients, there was a clear improvement in renal function (10.5 mL/min/1.73 m
CONCLUSIONS
CONCLUSIONS
A therapeutic switch from CNIs to everolimus and mycophenolate mofetil can improve renal function in patients with CNI nephrotoxicity, especially in those with a shorter time period from transplantation, without exposing them to a higher incidence of late acute rejection and cardiac allograft vasculopathy.
Identifiants
pubmed: 32113691
pii: S0041-1345(19)31686-0
doi: 10.1016/j.transproceed.2020.01.030
pii:
doi:
Substances chimiques
Calcineurin Inhibitors
0
Immunosuppressive Agents
0
Everolimus
9HW64Q8G6G
Mycophenolic Acid
HU9DX48N0T
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
836-842Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.