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Everolimus Initiati...
Everolimus Initiation With Early Calcineurin Inhibitor Withdrawal in De Novo Heart Transplant Recipients : Long-term Follow-up From the Randomized SCHEDULE Study
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- Gustafsson, Finn (författare)
- Copenhagen University Hospital,University of Copenhagen,Rigshosp, Denmark; Univ Copenhagen, Denmark
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- Andreassen, Arne K. (författare)
- Oslo university hospital,Oslo Univ Hosp, Norway,Sahlgrens Univ Hosp, Sweden,Sahlgrenska University Hospital
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- Andersson, Bert (författare)
- Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Sweden
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- Eiskjær, Hans (författare)
- Aarhus University Hospital,Aarhus Univ Hosp, Denmark
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- Rådegran, Göran (författare)
- Lund University,Lunds universitet,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Lund Univ, Sweden
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- Gude, Einar (författare)
- Oslo university hospital,Oslo Univ Hosp, Norway
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- Jansson, Kjell, 1956- (författare)
- Linköpings universitet,Linköping University,Östergötland County Council,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Fysiologiska kliniken US
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- Solbu, Dag (författare)
- Novartis Norge AS, Norway
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- Karason, Kristjan (författare)
- Sahlgrenska University Hospital
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- Arora, Satish (författare)
- Oslo university hospital,Oslo Univ Hosp, Norway
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- Dellgren, Göran (författare)
- Sahlgrenska University Hospital,Sahlgrens Univ Hosp, Sweden
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- Gullestad, Lars (författare)
- Oslo university hospital,University of Oslo,Oslo Univ Hosp, Norway; Univ Oslo, Norway; Univ Oslo, Norway
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(creator_code:org_t)
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- LIPPINCOTT WILLIAMS & WILKINS, 2020
- 2020
- Engelska 11 s.
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Ingår i: Transplantation. - : LIPPINCOTT WILLIAMS & WILKINS. - 1534-6080 .- 0041-1337. ; 104:1, s. 154-164
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: A calcineurin inhibitor (CNI)-free immunosuppressive regimen has been demonstrated to improve renal function early after heart transplantation, but long-term outcome of such a strategy has not been well described. METHODS: In the randomized SCHEDULE trial, de novo heart transplant recipients received (1) everolimus with reduced-exposure CNI (cyclosporine) followed by CNI withdrawal at week 7-11 posttransplant or (2) standard-exposure cyclosporine, both with mycophenolate mofetil and corticosteroids; 95/115 randomized patients were followed up at 5-7 years posttransplant. RESULTS: Mean measured glomerular filtration rate was 74.7 mL/min and 62.4 mL/min with everolimus and CNI, respectively. The mean difference was in favor of everolimus by 11.8 mL/min in the intent-to-treat population (P = 0.004) and 17.2 mL/min in the per protocol population (n = 75; P < 0.001). From transplantation to last follow-up, the incidence of biopsy-proven acute rejection (BPAR) was 77% (37/48) and 66% (31/47) (P = 0.23) with treated BPAR in 50% and 23% (P < 0.01) in the everolimus and CNI groups, respectively; no episode led to hemodynamic compromise. Coronary allograft vasculopathy (CAV) assessed by coronary intravascular ultrasound was present in 53% (19/36) and 74% (26/35) of everolimus- and CNI-treated patients, respectively (P = 0.037). Graft dimensions and function were similar between the groups. Late adverse events were comparable. CONCLUSIONS: These results suggest that de novo heart transplant patients randomized to everolimus and low-dose CNI followed by CNI-free therapy maintain significantly better long-term renal function as well as significantly reduced CAV than patients randomized to standard CNI treatment. Increased BPAR in the everolimus group during year 1 did not impair long-term graft function.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
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Till lärosätets databas
- Av författaren/redakt...
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Gustafsson, Finn
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Andreassen, Arne ...
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Andersson, Bert
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Eiskjær, Hans
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Rådegran, Göran
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Gude, Einar
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Jansson, Kjell, ...
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Solbu, Dag
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Karason, Kristja ...
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Arora, Satish
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Dellgren, Göran
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Gullestad, Lars
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Urologi och njur ...
- Artiklar i publikationen
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Transplantation
- Av lärosätet
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Lunds universitet
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Linköpings universitet