Low-dose and rapid steroid withdrawal in renal transplant patients treated with tacrolimus and mycophenolate mofetil

Immunosuppressive agents in solid organ transplantation: Mechanisms of action and therapeutic efficacy

“…Serum creatinine levels tended to be higher after steroid withdrawal. Further randomised controlled studies have confirmed that the incidence of acute rejection is similar or higher in patients undergoing steroid withdrawal at 3 months post-transplantation, though benefits include improvement in hypertension, hypercholesterolaemia and bone density [47][48][49][50].…”

Steroid Withdrawal in Renal Transplant Patients on Triple Therapy with a Calcineurin Inhibitor and Mycophenolate Mofetil: A Meta-analysis of Randomized, Controlled Trials

“…A second review allowed exclusion of 83 articles because they were not randomized trials or they were actually steroid-avoidance or steroid-free trials. As a result, 34 articles were selected for more detailed evaluation , and 6 of them were considered appropriate to be included in meta-analysis (Table 1) (15)(16)(17)(18)(19)(20). The principal reasons for exclusion were repeated reports, subgroup analysis of unique trials, and insufficient outcome data reported.…”

“…The other two trials examined prednisone withdrawal in patients receiving tacrolimus, MMF, and steroids (19,20). In all cyclosporine trials, the dose of MMF was 2 g/day; in both tacrolimus trials, the dose of MMF dose was 1 g/day (Table 1).…”

Multivariate Analysis of Risk Factors for Acute Rejection in Early Corticosteroid Cessation Regimens Under Modern Immunosuppression

“…A number of studies over the past several years have demonstrated the ability of new, potent immunosuppressive agents (mycophenolate mofetil (MMF), tacrolimus and sirolimus) to allow intermediate (within 3-6 months posttransplant) or early CSWD (i.e. within the first month posttransplant), or following tacrolimus rescue therapy for refractory rejection (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Moreover, experiences from other studies have indicated that induction therapy with potent T cell depleting antibodies can ablate the increased risk of acute rejection with CSWD (14).…”