A prospective, randomized clinical trial of cyclosporine reduction in stable patients greater than 12 months after renal transplantation

Abstract

This study suggests that a strategy consisting of a 50% CsA reduction is safe and is not associated with the increased risk of acute rejection observed in CsA withdrawal studies. It also has the potential to improve short-term allograft function and appears to reduce cardiovascular risk factors such as hypertension and hyperlipidemia.

Everolimus Plus Reduced‐Exposure CsA versus Mycophenolic Acid Plus Standard‐Exposure CsA in Renal‐Transplant Recipients

“…Eligible patients received basiliximab (20 mg) Tedesco Silva Jr. et al Everolimus Plus Reduced-Exposure CsA (19)(20)(21). Building upon previous data (8,12,13,22) The overall safety profile of everolimus was similar to that seen in previous studies (8,(11)(12)(13)(14); approximately 50 000 patient-years of everolimus experience now exists (24 …”

Improvement in renal function after everolimus introduction and calcineurin inhibitor reduction in maintenance thoracic transplant recipients: The significance of baseline glomerular filtration rate

“…6 However, guidelines do not recommend switching patients with severe pre-existing renal damage to everolimus therapy given the reported concerns of everolimus causing an increase in glomerular pressure and contributing to worsening proteinuria. [12][13][14] In the current study, 223 (79%) of included patients had a baseline mGFR of Ͻ 60 ml/min/1.73 m 2 , of which 25 (9%) had a mGFR of 20 to 29 ml/min/1.73 m 2 .…”

“…4 Although these histopathologic changes were previously considered irreversible, current data indicate that CNI dose reduction or elimination may improve renal function amongst Tx recipients with established CRF. [5][6][7] The proliferation signal inhibitors (PSIs) everolimus and sirolimus represent an attractive renal-sparing alternative to CNI therapy. These agents inhibit mammalian target of rapamycin (mTOR) causing blockage of T-cell activation.…”

Improvement in long-term graft survival in cadaveric renal transplant recipients treated with mycophenolate mofetil

“…However, maintenance with MMF, with a 50% CsA reduction after the first year post-transplantation, could be an alternative cost-effective strategy [26].…”