Improved outcome of steroid withdrawal in mycophenolate mofetil-treated primary cadaveric renal transplant recipients

Kupin, Warren; Venkat, K. K.; Goggins, M.; Douzdjian, Viken; Escobar, F; Mozes, Martin F.; Abouljoud, Marwan

doi:10.1016/s0041-1345(98)01933-2

Cited by 14 publications

(4 citation statements)

References 5 publications

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“…The multi‐centre study reported a significantly higher incidence of biopsy confirmed acute rejection within the first year for patients withdrawn from steroids (22.4% vs. 4.9%), yet we found no increase in acute rejection within the first year, or any time thereafter following steroid withdrawal (5% at 1 yr and 8.5% overall for each group). Rather, the acute rejection incidence in our study is similar to that previously reported by Kupin et al (25). Given that induction therapy did not improve the acute rejection incidence in the multi‐centre trial, our best explanation for the different outcomes for acute rejection incidence between these two studies is that either steroid withdrawal later than 6 months post‐transplant or the difference in CSA dosing or both improved the outcome in our study.…”

Section: Discussionsupporting

confidence: 93%

“…Some studies reporting weight change within the first year after steroid withdrawal found a significant difference when compared with a control population (16, 17, 35), whereas other studies did not (10, 14, 18, 19). Other studies with longer follow‐up either failed to show any improvement (36), or failed to show a sustained improvement (21, 22, 25), as in our study.…”

Section: Discussionsupporting

confidence: 55%

“…Indeed, these eras are marked by the clinical introduction of new drugs for immunosuppression. Thus, the results following steroid withdrawal in recipients transplanted during these different eras may differ substantially (25).…”

mentioning

confidence: 99%

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Prospective, randomized trial of steroid withdrawal in kidney recipients treated with mycophenolate mofetil and cyclosporine

Pelletier¹,

Akın²,

Ferguson³

2005

Clinical Transplantation

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 55%

See 1 more Smart Citation

Prospective, randomized trial of steroid withdrawal in kidney recipients treated with mycophenolate mofetil and cyclosporine

Pelletier¹,

Akın²,

Ferguson³

2005

Clinical Transplantation

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“…Furthermore, reduction of blood pressure has also been reported (15), albeit not unanimously (13, 14). Even though we were unable to demonstrate any reduction of blood pressure in our patient population, steroid withdrawal immunosuppression significantly reduced total cholesterol level at 1 yr post-transplantation.…”

Section: Discussionmentioning

confidence: 93%

Prospective Controlled Protocol for Three Months Steroid Withdrawal with Tacrolimus, Basiliximab, and Mycophenolate Mofetil in Renal Transplant Recipients

Kim

et al. 2012

J Korean Med Sci

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During the past few years, new immunosuppressants, such as tacrolimus, mycophenolate mofetil (MMF) and basiliximab, have been shown to successfully decrease the incidence of acute rejection, possibly acting as potent substrates for safe steroid withdrawal. Therefore, clinical outcome of 3 months steroid withdrawal, while using the above immunosuppressants, was analyzed. Clinical trial registry No. was NCT 01550445. Thirty de novo renal transplant recipients were enrolled, and prednisolone was slowly withdrawn 3 months post-transplantation by 2.5 mg at every two weeks, until 8 weeks. During steroid withdrawal, 10 patients (30.0%) discontinued the protocol and they were maintained on steroid treatment. Among 20 steroid free patients, 8 patients (40.0%) re-started the steroid within 12 months post-transplantation. By the study endpoint, 12 (40%) recipients did not take steroid and survival of patients and grafts was 100%. In conclusion, in kidney transplant patients, 3 months steroid withdrawal while taking tacrolimus, basiliximab and mycophenolate mofetil was not associated with increased mortality or graft loss. Despite various causes of failure of steroid withdrawal during the follow-up period, it is a strategy well advised for kidney transplant recipients with regard to long-term steroid-related complications.

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Steroid avoidance or withdrawal for kidney transplant recipients

Pascual

Zamora

Galeano

et al. 2009

Cochrane Database of Systematic Reviews

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Background Steroid-sparing strategies have been attempted in recent decades to avoid morbidity from long-term steroid intake among kidney transplant recipients. Previous systematic reviews of steroid withdrawal after kidney transplantation have shown a significant increase in acute rejection. There are various protocols to withdraw steroids after kidney transplantation and their possible benefits or harms are subject to systematic review. This is an update of a review first published in 2009. Objectives To evaluate the benefits and harms of steroid withdrawal or avoidance for kidney transplant recipients. Search methods We searched the Cochrane Kidney and Transplant Specialised Register to 15 February 2016 through contact with the Information Specialist using search terms relevant to this review. Selection criteria All randomised and quasi-randomised controlled trials (RCTs) in which steroids were avoided or withdrawn at any time point after kidney transplantation were included.

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Improved outcome of steroid withdrawal in mycophenolate mofetil-treated primary cadaveric renal transplant recipients

Cited by 14 publications

References 5 publications

Prospective, randomized trial of steroid withdrawal in kidney recipients treated with mycophenolate mofetil and cyclosporine

Prospective, randomized trial of steroid withdrawal in kidney recipients treated with mycophenolate mofetil and cyclosporine

Prospective Controlled Protocol for Three Months Steroid Withdrawal with Tacrolimus, Basiliximab, and Mycophenolate Mofetil in Renal Transplant Recipients

Steroid avoidance or withdrawal for kidney transplant recipients

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