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Tacrolimus-Based, S...
Tacrolimus-Based, Steroid-Free Regimens in Renal Transplantation : 3-Year Follow-Up of the ATLAS Trial
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Kraemer, Bernhard K. (author)
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Klinger, Marian (author)
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Vitko, Stefan (author)
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Glyda, Maciej (author)
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Midtvedt, Karsten (author)
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Stefoni, Sergio (author)
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Citterio, Franco (author)
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Pietruck, Frank (author)
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Squifflet, Jean-Paul (author)
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Segoloni, Giuseppe (author)
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Krueger, Bernd (author)
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Sperschneider, Heide (author)
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Banas, Bernhard (author)
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- Bäckman, Lars (author)
- Uppsala universitet,Transplantationskirurgi
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Weber, Markus (author)
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Carmellini, Mario (author)
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Perner, Ferenc (author)
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Claesson, Kerstin (author)
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Marcinkowski, Wojciech (author)
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Ostrowski, Marek (author)
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Senatorski, Grzegorz (author)
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- Nordstrom, Johan (author)
- Karolinska Institutet
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Salmela, Kaija (author)
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(creator_code:org_t)
- 2012
- 2012
- English.
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In: Transplantation. - 0041-1337 .- 1534-6080. ; 94:5, s. 492-498
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background. Long-term use of corticosteroids is associated with considerable morbidity, including cardiovascular and metabolic adverse effects. Methods. This study evaluated the long-term efficacy and safety of two steroid-free regimens compared with a triple immunosuppressive therapy in renal transplant recipients. This was a 3-year follow-up to a 6-month, open-label, randomized, multicenter study. Results. Data from 3 years were available for 421 (93.3%) of 451 patients in the original intent-to-treat population (143 tacrolimus/basiliximab [Tac/Bas], 139 tacrolimus/mycophenolate mofetil [Tac/MMF], and 139 tacrolimus/MMF/steroids [triple therapy]). In the time interval from 6 months to 3 years after transplantation, the incidence of biopsy-proven acute rejection was low and similar (Tac/Bas, 2.1%; Tac/MMF, 2.2%; triple therapy, 2.2%); Most rejection episodes occurred during the first 6 months of the study. Graft survival was high (Kaplan-Meier estimates: 92.7%, 92.5%, and 92.5%), as was patient survival (93.1%, 96.4%, and 97.0%). There were 10 graft losses (n=2, 4, and 4) and 12 patient deaths (n=5, 2, and 5). Renal function was well preserved throughout the study and similar between groups. There was a trend toward improved cardiovascular risk factors in the Tac/Bas group, including reduced total and low-density lipoprotein cholesterol and lower new-onset insulin use. There were no between-group differences in the incidence or type of adverse events. Conclusion. Higher rates of acute rejection early in treatment were seen with the steroid-free regimens, but this did not translate into poorer long-term outcomes, such as graft and patient survival and renal function. A trend for a more favorable cardiovascular risk profile was observed for steroid-free immunosuppression with Tac/Bas.
Keyword
- Tacrolimus
- Renal transplant
- Immunosuppression
- Steroid
- Long term
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Kraemer, Bernhar ...
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Klinger, Marian
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Vitko, Stefan
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Glyda, Maciej
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Midtvedt, Karste ...
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Stefoni, Sergio
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show more...
-
Citterio, Franco
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Pietruck, Frank
-
Squifflet, Jean- ...
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Segoloni, Giusep ...
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Krueger, Bernd
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Sperschneider, H ...
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Banas, Bernhard
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Bäckman, Lars
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Weber, Markus
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Carmellini, Mari ...
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Perner, Ferenc
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Claesson, Kersti ...
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Marcinkowski, Wo ...
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Ostrowski, Marek
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Senatorski, Grze ...
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Nordstrom, Johan
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Salmela, Kaija
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show less...
- Articles in the publication
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Transplantation
- By the university
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Uppsala University
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Karolinska Institutet