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Search: id:"swepub:oai:lup.lub.lu.se:aa04283e-d7c9-4510-af77-c47a4bcc577b" > Reduced exposure to...

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  • Ekberg, HenrikLund University,Lunds universitet,Enheten för forskning kring njurfunktion och njursjukdom,Kirurgi,Forskargrupper vid Lunds universitet,Renal Research Unit,Surgery,Lund University Research Groups (author)

Reduced exposure to calcineurin inhibitors in renal transplantation.

  • Article/chapterEnglish2007

Publisher, publication year, extent ...

  • 2007

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:aa04283e-d7c9-4510-af77-c47a4bcc577b
  • https://lup.lub.lu.se/record/1035046URI
  • https://doi.org/10.1056/NEJMoa067411DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. RESULTS: The mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). CONCLUSIONS: A regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. (ClinicalTrials.gov number, NCT00231764 [ClinicalTrials.gov].).

Subject headings and genre

  • MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
  • MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
  • Adrenal Cortex Hormones: administration & dosage
  • Adrenal Cortex Hormones: therapeutic use
  • Antibodies
  • Monoclonal: administration & dosage
  • Calcineurin: antagonists & inhibitors
  • Cyclosporine: administration & dosage
  • Diabetes Mellitus: etiology
  • Graft Rejection: prevention & control
  • Enzyme Inhibitors: administration & dosage
  • Immunoglobulin G: administration & dosage
  • Immunosuppressive Agents: adverse effects
  • Immunosuppressive Agents: administration & dosage
  • Immunosuppressive Agents: therapeutic use
  • Mycophenolic Acid: analogs & derivatives
  • Mycophenolic Acid: administration & dosage
  • Prednisone: administration & dosage
  • Sirolimus: administration & dosage
  • Sirolimus: adverse effects
  • Tacrolimus: administration & dosage

Added entries (persons, corporate bodies, meetings, titles ...)

  • Tedesco-Silva, Helio (author)
  • Demirbas, Alper (author)
  • Vítko, Stefan (author)
  • Nashan, Björn (author)
  • Gürkan, Alp (author)
  • Margreiter, Raimund (author)
  • Hugo, Christian (author)
  • Grinyó, Josep M (author)
  • Frei, Ulrich (author)
  • Vanrenterghem, Yves (author)
  • Daloze, Pierre (author)
  • Halloran, Philip F (author)
  • Enheten för forskning kring njurfunktion och njursjukdomKirurgi (creator_code:org_t)

Related titles

  • In:New England Journal of Medicine357:25, s. 2562-25750028-4793

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