Safety profile comparing azathioprine and mycophenolate in kidney transplant recipients receiving tacrolimus and corticosteroids

Abstract

The type of antimetabolite, AZA or MPA, was not independently associated with any safety or efficacy outcome 5 years after transplantation, suggesting that AZA is still a viable option for low-risk KTR receiving TAC and steroids.

Long-term efficacy, tolerability and retention rate of azathioprine in 103 aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder patients: a multicentre retrospective observational study from the UK

“…5 However, predicted discontinuation rates of 53% by five years in our study was lower (60%) than in larger series of patients (n = 662) treated with AZA for other disorders. 36 Nine per cent (n = 9) of patients included in this study died during the observation period while on AZA; at first sight this might seem disproportionately high. But scrutiny of the clinical features of this group indicates that the AZA may be less likely to be responsible for the deaths.…”

“…5 However, predicted discontinuation rates of 53% by five years in our study was lower (60%) than in larger series of patients ( n = 662) treated with AZA for other disorders. 36…”

“…In a study of AZA in renal transplant recipients ( n = 662), infection-related mortality was 4% ( n = 29) and cardiovascular mortality was 2% ( n = 14). 36 The higher proportion of such events in NMO may reflect the substantial baseline disability of the group that died (median EDSS 7.5) versus those that did not (median EDSS 5.5).…”

What are the maternal risks and pregnancy outcomes after kidney transplantation?

“…On contrast, among women with kidney transplantation, studies reported that approximately 35% of pregnancies do not progress beyond the 1st trimester due to spontaneous or therapeutic abortion and that overall success rate is > 90% after the 1st trimester. [34] The contradiction in results may be due to stopping of mycophenolate in the current sample which has influenced the current results. Moreover some of the studies included in the aforementioned systemic review were before FDA categorization of Mycophenolate mofetil as pregnancy category D so it was increasing the incidence of abortion.…”

“…As for the increase in creatinine and decrease in eGFR along pregnancy and at follow-up visits after delivery; in the available published data, pregnancy did not appear to massively affect kidney conditions in stable transplant women. [34] The demographic characteristics of the current studied women may be different. The immunosuppression regimen and the number of visits during pregnancy were different compared to several studies contributing to the different results.…”