Temporal and spatial variability of immunosuppressive therapies in transplant patients: An observational study in Italy.
drug utilization
immunosuppressive therapy
real-world evidence
solid organ transplant
space–time variability
Journal
Frontiers in transplantation
ISSN: 2813-2440
Titre abrégé: Front Transplant
Pays: Switzerland
ID NLM: 9918573988006676
Informations de publication
Date de publication:
2022
2022
Historique:
received:
03
10
2022
accepted:
23
11
2022
medline:
16
1
2023
pubmed:
16
1
2023
entrez:
12
7
2024
Statut:
epublish
Résumé
In immunosuppression after transplantation, several multi-drug approaches are used, involving calcineurin inhibitors ( An Italian multicentre observational cohort study was conducted using health information systems. Patients with incident transplant during 2009-2019 and resident in four regions (Veneto, Lombardy, Lazio, and Sardinia) were enrolled. The post-transplant immunosuppressive regimen was evaluated by organ, region, and year. The most dispensed regimen was triple-drug therapy for the kidneys [tacrolimus (TAC) + antiM + corticosteroids = 41.5%] and heart [cyclosporin + antiM + corticosteroids = 36.6%] and double-drug therapy for liver recipients (TAC + corticosteroids = 35.4%). Several differences between regions and years emerged with regard to agents and the number of drugs used. A high heterogeneity in immunosuppressive therapy post-transplant was found. Further studies are needed in order to investigate the reasons for this variability and to evaluate the risk-benefit profile of treatment schemes adopted in clinical practice.
Sections du résumé
Background
UNASSIGNED
In immunosuppression after transplantation, several multi-drug approaches are used, involving calcineurin inhibitors (
Methods
UNASSIGNED
An Italian multicentre observational cohort study was conducted using health information systems. Patients with incident transplant during 2009-2019 and resident in four regions (Veneto, Lombardy, Lazio, and Sardinia) were enrolled. The post-transplant immunosuppressive regimen was evaluated by organ, region, and year.
Results
UNASSIGNED
The most dispensed regimen was triple-drug therapy for the kidneys [tacrolimus (TAC) + antiM + corticosteroids = 41.5%] and heart [cyclosporin + antiM + corticosteroids = 36.6%] and double-drug therapy for liver recipients (TAC + corticosteroids = 35.4%). Several differences between regions and years emerged with regard to agents and the number of drugs used.
Conclusion
UNASSIGNED
A high heterogeneity in immunosuppressive therapy post-transplant was found. Further studies are needed in order to investigate the reasons for this variability and to evaluate the risk-benefit profile of treatment schemes adopted in clinical practice.
Identifiants
pubmed: 38994384
doi: 10.3389/frtra.2022.1060621
pmc: PMC11235261
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1060621Informations de copyright
© 2023 Marino, Rosa, Finocchietti, Bellini, Poggi, Massari, Alegiani, Masiero, Ricci, Bedeschi, Puoti, Cardillo, Pierobon, Nordio, Ferroni, Zanforlini, Piccolo, Leoni, Ledda, Carta, Garau, Lucenteforte, Davoli, Addis and Belleudi.
Déclaration de conflit d'intérêts
MZ was employed by ARIA, S.p.a. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.