Everolimus-Based Immunosuppression Therapy for BK Virus Nephropathy

Polanco, Natalia; Monte, Esther González; Folgueira, Lola; Morales, Enrique; Martínez, E. Gutiérrez; Bengoa, I. Ocerin; Hernández, Ana; Morales, José; Praga, Manuel; Andrés, Amado

doi:10.1016/j.transproceed.2014.11.008

Cited by 31 publications

(18 citation statements)

References 15 publications

(13 reference statements)

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“…In our study, it is noticeable that the increased BKPyV loads in the EVL group are detectable up to 24 months, and this contradicts observations associating EVL with reduced BKPyV replication, compared to other immunosuppressants . Data of the pleiotropic effect of EVL and the involved mechanisms are scarce and show multiple modes of action.…”

Section: Discussioncontrasting

confidence: 99%

Incidence and outcome of BK polyomavirus infection in a multicenter randomized controlled trial with renal transplant patients receiving cyclosporine‐, mycophenolate sodium‐, or everolimus‐based low‐dose immunosuppressive therapy

Doesum

Gard

Bemelman

et al. 2017

Transplant Infectious Dis

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Incidence and outcome of BK polyomavirus infection in a multicenter randomized controlled trial with renal transplant patients receiving cyclosporine-, mycophenolate sodium-, or everolimus-based low-dose immunosuppressive therapy van Doesum, Willem B.; Gard, Lilli; Bemelman, Frederike J.; de Fijter, Johan W.; van der Heide, Jaap J. Homan; Niesters, Hubert G.; van Son, Willem J.; Stegeman, Coen A.; Groen, Henk; Riezebos-Brilman, Annelies Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 11-04-2019 Accepted ArticleThis article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/tid.12687 This article is protected by copyright. All rights reserved. Accepted ArticleThis article is protected by copyright. All rights reserved. Accepted ArticleThis article is protected by copyright. All rights reserved. Conclusions: Treatment with MPS was associated with an increased incidence of BK viruria. Dual immunosuppressive therapy with CsA and Pred was associated with the lowest rate of BKPyV replication and the fastest clearance of the virus.

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Section: Discussioncontrasting

confidence: 99%

Incidence and outcome of BK polyomavirus infection in a multicenter randomized controlled trial with renal transplant patients receiving cyclosporine‐, mycophenolate sodium‐, or everolimus‐based low‐dose immunosuppressive therapy

Doesum

Gard

Bemelman

et al. 2017

Transplant Infectious Dis

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“…In nine RTR, who developed BKVN, Tac was converted to everolimus, and MPA ceased resulting in significant improvement in renal function. BKV clearance was reported in five and significant reduction in viremia in the remaining four RTR . Everolimus with low dose Cs A was found to be associated with lower incidence of BKVN compared with Cs A and MPA combination in new RTR .…”

Section: Treatment Of Bk Virus Nephropathymentioning

confidence: 88%

“…BKV clearance was reported in five and significant reduction in viremia in the remaining four RTR. 41 Everolimus with low dose Cs A was found to be associated with lower incidence of BKVN compared with Cs A and MPA combination in new RTR. 42 A larger study of everolimus is under way at the University of California, San Francisco (ClinicalTrials.gov, identifier: NCT01624948).…”

Section: Treatment Of Bk Virus Nephropathymentioning

confidence: 88%

BK virus nephropathy in renal transplant recipients

Jamboti

2016

Nephrology

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ABSTRACT:BK virus nephropathy (BKVN) occurs in up to 10% of renal transplant recipients and can result in graft loss. The reactivation of BK virus in renal transplant recipients is largely asymptomatic, and routine surveillance especially in the first 12-24 months after transplant is necessary for early recognition and intervention. Reduced immunosuppression and anti-viral treatment in the early stages may be effective in stopping BK virus replication. Urinary decoy cells, although highly specific, lack sensitivity to diagnose BKVN. Transplant biopsy remains the gold standard to diagnose BKVN, good surrogate markers for surveillance using quantitative urinary decoy cells, urinary SV40 T immunochemical staining or polyoma virus-Haufen bodies are offered by recent studies. Advanced BKVN results in severe tubulo-interstitial damage and graft failure. Retransplantation after BKVN is associated with good outcomes. Newer treatment modalities are emerging.

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“…demonstrated a decreased incidence of BK in patients with a higher trough level of everolimus (6‐12 ng/mL) in comparison to patients on a lower trough level of everolimus (3‐8 ng/mL). Polanko et al . showed that evolution of renal function was positive in BK‐affected patients after conversion from TAC to everolimus in a mycophenolate‐based regimen.…”

Section: Discussionmentioning

confidence: 99%