Renal function three years after early conversion from a calcineurin inhibitor to everolimus: results from a randomized trial in kidney transplantation

Mjörnstedt, Lars,1956Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery (author)

Renal function three years after early conversion from a calcineurin inhibitor to everolimus : results from a randomized trial in kidney transplantation

In a 36-month, open-label, multicenter trial, 202 kidney transplant recipients were randomized at week 7 post-transplant to convert to everolimus or remain on cyclosporine: 182 were analyzed to month 36 (92 everolimus, 90 controls). Mean (SD) change in measured GFR (mGFR) from randomization to month 36 was 1.3 (14.0)ml/min with everolimus versus -1.7 (15.4)ml/min in controls (P=0.210). In patients who remained on treatment, mean mGFR improved from randomization to month 36 by 7.9 (11.5)ml/min with everolimus (n=37) but decreased by 1.4 (14.7)ml/min in controls (n=62) (P=0.001). During months 12-36, death-censored graft survival was 100%, patient survival was 98.9% and 96.7% in the everolimus and control groups, respectively, and 13.0% and 11.1% of everolimus and control patients, respectively, experienced mild biopsy-proven acute rejection (BPAR). Protocol biopsies in a limited number of on-treatment patients showed similar interstitial fibrosis progression. Donor-specific antibodies were present at month 36 in 6.3% (2/32) and 18.0% (9/50) of on-treatment everolimus and control patients with available data (P=0.281). During months 12-36, adverse events were comparable, but discontinuation was more frequent with everolimus (33.7% vs. 10.0%). Conversion from cyclosporine to everolimus at 7weeks post-transplant was associated with a significant benefit in renal function at 3years when everolimus was continued.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
calcineurin inhibitor
conversion
everolimus
glomerular filtration rate
kidney transplantation
long-term
renal function
calcineurin inhibitor;conversion;everolimus;glomerular filtration rate;kidney transplantation;long-term;renal function

Sorensen, Soren Schwartz (author)
von zur Mühlen, BengtUppsala universitet,Transplantationskirurgi(Swepub:uu)bengmuhl (author)
Jespersen, Bente (author)
Hansen, Jesper M. (author)
Bistrup, Claus (author)
Andersson, Helene (author)
Gustafsson, Bengt I.,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xgusbe (author)
Solbu, Dag (author)
Holdaas, Hallvard (author)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi (creator_code:org_t)

By the author/editor: Mjörnstedt, Lars ...; Sorensen, Soren ...; von zur Mühlen, ...; Jespersen, Bente; Hansen, Jesper M ...; Bistrup, Claus; show more...; Andersson, Helen ...; Gustafsson, Beng ...; Solbu, Dag; Holdaas, Hallvar ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

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