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

Pelletier, Ronald P.; Akın, Barış; Ferguson, Ronald M.

doi:10.1111/j.1399-0012.2005.00430.x

Cited by 35 publications

(20 citation statements)

References 35 publications

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“…Similar results were observed in a subset of patients in the study by Pelletier et al (35,36), in whom BMD in both the spine and hip increased in the steroid withdrawal group during the first year after withdrawal. No significant change was seen in the patients continuing steroids.…”

Section: Other Outcomessupporting

confidence: 86%

Steroid Avoidance or Withdrawal After Renal Transplantation Increases the Risk of Acute Rejection but Decreases Cardiovascular Risk. A Meta-Analysis

2010

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Section: Other Outcomessupporting

confidence: 86%

Steroid Avoidance or Withdrawal After Renal Transplantation Increases the Risk of Acute Rejection but Decreases Cardiovascular Risk. A Meta-Analysis

2010

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“…We included nine RCTs including 1820 patients assessing SW compared with steroid maintenance in patients with MMF or MFS as a third drug (11)(12)(13)(14)(15)(16)(17)(18)(19). None included mammalian target of rapamycin (mTOR) inhibitors.…”

Section: Description Of Studiesmentioning

confidence: 99%

A Systematic Review on Steroid Withdrawal Between 3 and 6 Months After Kidney Transplantation

et al. 2010

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SW after 3 to 6 months of kidney transplantation is associated with increased rates of acute rejection only if CsA is used but not with tacrolimus. Graft function and survival remain stable up to 3 years after transplantation, the longest follow-up reported. The interest for late SW has decreased during the past years in the literature. More trials with carefully designed outcome measures are needed in patients treated with low-exposure tacrolimus and mycophenolic acid derivatives.

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“…A single-center trial comparing steroid withdrawal versus maintenance steroids with MMF and cyclosporine therapy indicated that there was no difference in the incidence of NODAT. However, corticosteroid weaning was only started approximately 450 days after transplantation, and NODAT was reported in only 10/118 (8.5%) of patients (16). In the FREEDOM study, recipients were randomized to steroids, no steroids, or steroids to day 7 with maintenance therapy consisting of cyclosporine, mycophenolate sodium and basiliximab induction (17).…”

Section: Discussionmentioning

confidence: 99%

New-Onset Diabetes After Transplantation:Results From a Double-Blind Early Corticosteroid Withdrawal Trial

Pirsch

Henning

First

et al. 2015

American Journal of Transplantation

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New-onset diabetes after transplantation (NODAT) is an important complication following kidney transplantation. Data from the 5-year early steroid withdrawal double-blind randomized trial were analyzed to determine if steroid avoidance reduced the NODAT risk. Incidence, timing and risk factors for NODAT were evaluated using eight definitions. By American Diabetes Association definition, 36.3% of patients on chronic corticosteroids (CCS) and 35.9% on early corticosteroid withdrawal (CSWD) were diagnosed with NODAT by 5 years. The definition combining fasting blood glucose !126 mg/dL on two occasions or treatment identified slightly more cases of NODAT: CCS (39.3%) and CSWD (39.4%). Through 5 years posttransplant, the proportion of NODAT patients requiring treatment were similar (CSWD 22.5% vs. CCS 21.5%); however, insulin therapy was lower with CSWD (3.7% vs. 11.6%; p ¼ 0.049). By multivariate analysis, only age, but not corticosteroid use, was a significant risk factor for NODAT for more than one definition. Numerical, but not statistically significant trends toward lower NO-DAT rates with CSWD were observed through 5 years for insulin use, HbA1c !6.0% and !6.5% on two occasions. This prospective, randomized trial of CSWD indicates that CSWD has a limited impact in reducing NODAT when compared to low-dose prednisone (5 mg/day from month 6 to 5 years).

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

Abstract: Steroid withdrawal in low risk kidney transplant recipients is safe and ameliorates many of the unwanted sides effects of steroid use.

Cited by 35 publications

References 35 publications

Steroid Avoidance or Withdrawal After Renal Transplantation Increases the Risk of Acute Rejection but Decreases Cardiovascular Risk. A Meta-Analysis

Steroid Avoidance or Withdrawal After Renal Transplantation Increases the Risk of Acute Rejection but Decreases Cardiovascular Risk. A Meta-Analysis

A Systematic Review on Steroid Withdrawal Between 3 and 6 Months After Kidney Transplantation

New-Onset Diabetes After Transplantation:Results From a Double-Blind Early Corticosteroid Withdrawal Trial

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