Safety and efficacy of the early introduction of everolimus with reduced-exposure cyclosporine A in de novo kidney recipients

Chang Kwon Oh, Kyu Ha Huh, Jongwon Ha, Yeong Hoon Kim, Yong Lim Kim, Yu Seun Kim

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Methods. A comparative, parallel, randomized, open-label 1-year study has been performed in 148 patients from five transplant centers to compare the efficacy and tolerability of everolimus and reduced exposure CsA (the investigational group) or enteric-coated mycophenolate sodium and standard-exposure CsA (the control group) in combination with basiliximab and steroids. The eligible subjects were randomly assigned at 1 month after transplantation. Efficacy failure (biopsy-proven acute rejection, death, graft loss, or loss to follow-up), safety, and renal function were evaluated.

Results. One graft loss has been reported in the control group and no patient death were reported in either group. The incidence of biopsy-proven acute rejection until 12 months after transplantation of the investigational group was 7.5%, compared to 11.1% of the control group (P=0.565). The mean estimated glomerular filtration rates of the investigational group at 12 months after transplantation was significantly higher (68.1±16.8 ml/min/1.73 m2) than that of the control group (60.6±15.8 ml/min/1.73 m2; P=0.016). There was no significant difference (P>0.05) in the incidence of discontinuations and serious adverse events between the groups.

Conclusion. The results of this study provide the evidences that (1) the calcineurin inhibitor (CNI) minimization by the introduction of everolimus after 1-month posttransplantation keeps the incidences of acute rejection and addtional risks as low as the conventional immunosuppression; (2) it allows minimizing CNI exposure, consequently reducing CNI nephrotoxicity and preserving renal function.

Background. Everolimus and cyclosporine A (CsA) exhibit synergistic immunosuppressive activity when used in combination. We examined the safety and efficacy of the use of everolimus with a cyclosporine-sparing strategy in de novo renal transplant recipients.

Original languageEnglish
Pages (from-to)180-186
Number of pages7
JournalTransplantation
Volume99
Issue number1
DOIs
Publication statusPublished - 2015 Jan 15

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Cyclosporine
Kidney
Safety
Control Groups
Transplantation
Incidence
Mycophenolic Acid
Transplants
Biopsy
Graft Rejection
Immunosuppressive Agents
Glomerular Filtration Rate
Immunosuppression
Steroids
Everolimus
Calcineurin Inhibitors

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Oh, Chang Kwon ; Huh, Kyu Ha ; Ha, Jongwon ; Kim, Yeong Hoon ; Kim, Yong Lim ; Kim, Yu Seun. / Safety and efficacy of the early introduction of everolimus with reduced-exposure cyclosporine A in de novo kidney recipients. In: Transplantation. 2015 ; Vol. 99, No. 1. pp. 180-186.
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abstract = "Methods. A comparative, parallel, randomized, open-label 1-year study has been performed in 148 patients from five transplant centers to compare the efficacy and tolerability of everolimus and reduced exposure CsA (the investigational group) or enteric-coated mycophenolate sodium and standard-exposure CsA (the control group) in combination with basiliximab and steroids. The eligible subjects were randomly assigned at 1 month after transplantation. Efficacy failure (biopsy-proven acute rejection, death, graft loss, or loss to follow-up), safety, and renal function were evaluated.Results. One graft loss has been reported in the control group and no patient death were reported in either group. The incidence of biopsy-proven acute rejection until 12 months after transplantation of the investigational group was 7.5{\%}, compared to 11.1{\%} of the control group (P=0.565). The mean estimated glomerular filtration rates of the investigational group at 12 months after transplantation was significantly higher (68.1±16.8 ml/min/1.73 m2) than that of the control group (60.6±15.8 ml/min/1.73 m2; P=0.016). There was no significant difference (P>0.05) in the incidence of discontinuations and serious adverse events between the groups.Conclusion. The results of this study provide the evidences that (1) the calcineurin inhibitor (CNI) minimization by the introduction of everolimus after 1-month posttransplantation keeps the incidences of acute rejection and addtional risks as low as the conventional immunosuppression; (2) it allows minimizing CNI exposure, consequently reducing CNI nephrotoxicity and preserving renal function.Background. Everolimus and cyclosporine A (CsA) exhibit synergistic immunosuppressive activity when used in combination. We examined the safety and efficacy of the use of everolimus with a cyclosporine-sparing strategy in de novo renal transplant recipients.",
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Safety and efficacy of the early introduction of everolimus with reduced-exposure cyclosporine A in de novo kidney recipients. / Oh, Chang Kwon; Huh, Kyu Ha; Ha, Jongwon; Kim, Yeong Hoon; Kim, Yong Lim; Kim, Yu Seun.

In: Transplantation, Vol. 99, No. 1, 15.01.2015, p. 180-186.

Research output: Contribution to journalArticle

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T1 - Safety and efficacy of the early introduction of everolimus with reduced-exposure cyclosporine A in de novo kidney recipients

AU - Oh, Chang Kwon

AU - Huh, Kyu Ha

AU - Ha, Jongwon

AU - Kim, Yeong Hoon

AU - Kim, Yong Lim

AU - Kim, Yu Seun

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N2 - Methods. A comparative, parallel, randomized, open-label 1-year study has been performed in 148 patients from five transplant centers to compare the efficacy and tolerability of everolimus and reduced exposure CsA (the investigational group) or enteric-coated mycophenolate sodium and standard-exposure CsA (the control group) in combination with basiliximab and steroids. The eligible subjects were randomly assigned at 1 month after transplantation. Efficacy failure (biopsy-proven acute rejection, death, graft loss, or loss to follow-up), safety, and renal function were evaluated.Results. One graft loss has been reported in the control group and no patient death were reported in either group. The incidence of biopsy-proven acute rejection until 12 months after transplantation of the investigational group was 7.5%, compared to 11.1% of the control group (P=0.565). The mean estimated glomerular filtration rates of the investigational group at 12 months after transplantation was significantly higher (68.1±16.8 ml/min/1.73 m2) than that of the control group (60.6±15.8 ml/min/1.73 m2; P=0.016). There was no significant difference (P>0.05) in the incidence of discontinuations and serious adverse events between the groups.Conclusion. The results of this study provide the evidences that (1) the calcineurin inhibitor (CNI) minimization by the introduction of everolimus after 1-month posttransplantation keeps the incidences of acute rejection and addtional risks as low as the conventional immunosuppression; (2) it allows minimizing CNI exposure, consequently reducing CNI nephrotoxicity and preserving renal function.Background. Everolimus and cyclosporine A (CsA) exhibit synergistic immunosuppressive activity when used in combination. We examined the safety and efficacy of the use of everolimus with a cyclosporine-sparing strategy in de novo renal transplant recipients.

AB - Methods. A comparative, parallel, randomized, open-label 1-year study has been performed in 148 patients from five transplant centers to compare the efficacy and tolerability of everolimus and reduced exposure CsA (the investigational group) or enteric-coated mycophenolate sodium and standard-exposure CsA (the control group) in combination with basiliximab and steroids. The eligible subjects were randomly assigned at 1 month after transplantation. Efficacy failure (biopsy-proven acute rejection, death, graft loss, or loss to follow-up), safety, and renal function were evaluated.Results. One graft loss has been reported in the control group and no patient death were reported in either group. The incidence of biopsy-proven acute rejection until 12 months after transplantation of the investigational group was 7.5%, compared to 11.1% of the control group (P=0.565). The mean estimated glomerular filtration rates of the investigational group at 12 months after transplantation was significantly higher (68.1±16.8 ml/min/1.73 m2) than that of the control group (60.6±15.8 ml/min/1.73 m2; P=0.016). There was no significant difference (P>0.05) in the incidence of discontinuations and serious adverse events between the groups.Conclusion. The results of this study provide the evidences that (1) the calcineurin inhibitor (CNI) minimization by the introduction of everolimus after 1-month posttransplantation keeps the incidences of acute rejection and addtional risks as low as the conventional immunosuppression; (2) it allows minimizing CNI exposure, consequently reducing CNI nephrotoxicity and preserving renal function.Background. Everolimus and cyclosporine A (CsA) exhibit synergistic immunosuppressive activity when used in combination. We examined the safety and efficacy of the use of everolimus with a cyclosporine-sparing strategy in de novo renal transplant recipients.

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