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Titolo:
Sirolimus (rapamycin)-based therapy in human renal transplantation - Similar efficacy and different toxicity compared with cyclosporine
Autore:
Groth, CG; Backman, L; Morales, JM; Calne, R; Kreis, H; Lang, P; Touraine, JL; Claesson, K; Campistol, JM; Durand, D; Wramner, L; Brattstrom, C; Charpentier, B;
Indirizzi:
Karolinska Inst, Huddinge Hosp, S-10401 Stockholm, Sweden Karolinska InstStockholm Sweden S-10401 Hosp, S-10401 Stockholm, Sweden Sahlgrens Univ Hosp, S-41345 Gothenburg, Sweden Sahlgrens Univ Hosp Gothenburg Sweden S-41345 S-41345 Gothenburg, Sweden Hosp 12 Octubre, E-28041 Madrid, Spain Hosp 12 Octubre Madrid Spain E-28041 p 12 Octubre, E-28041 Madrid, Spain Addenbrookes Hosp, Cambridge, England Addenbrookes Hosp Cambridge England denbrookes Hosp, Cambridge, England Hop Necker Enfants Malad, Paris, France Hop Necker Enfants Malad Paris France cker Enfants Malad, Paris, France Hop Henri Mondor, F-94010 Creteil, France Hop Henri Mondor Creteil France F-94010 Mondor, F-94010 Creteil, France Hop Edouard Herriot, Lyon, France Hop Edouard Herriot Lyon FranceHop Edouard Herriot, Lyon, France Univ Uppsala Hosp, Uppsala, Sweden Univ Uppsala Hosp Uppsala SwedenUniv Uppsala Hosp, Uppsala, Sweden Hosp Clin Barcelona, Barcelona, Spain Hosp Clin Barcelona Barcelona Spain sp Clin Barcelona, Barcelona, Spain Univ Hosp Rangueil, Toulouse, France Univ Hosp Rangueil Toulouse FranceUniv Hosp Rangueil, Toulouse, France Hop Bicetre, Kremlin Bicetre, France Hop Bicetre Kremlin Bicetre FranceHop Bicetre, Kremlin Bicetre, France Huddinge Hosp, Dept Transplant Surg, S-14186 Huddinge, Sweden Huddinge Hosp Huddinge Sweden S-14186 ant Surg, S-14186 Huddinge, Sweden
Titolo Testata:
TRANSPLANTATION
fascicolo: 7, volume: 67, anno: 1999,
pagine: 1036 - 1042
SICI:
0041-1337(19990415)67:7<1036:S(TIHR>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALLOGRAFT-REJECTION; MYCOPHENOLATE MOFETIL; RAPAMYCIN; RECIPIENTS; NEPHROTOXICITY; PROLIFERATION; AZATHIOPRINE; PNEUMONITIS; PREVENTION; TACROLIMUS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Groth, CG Huddinge Hosp, Dept Transplant Surg, S-14186 Huddinge, Sweden Huddinge Hosp Huddinge Sweden S-14186 S-14186 Huddinge, Sweden
Citazione:
C.G. Groth et al., "Sirolimus (rapamycin)-based therapy in human renal transplantation - Similar efficacy and different toxicity compared with cyclosporine", TRANSPLANT, 67(7), 1999, pp. 1036-1042

Abstract

Background Sirolimus (rapamycin) is a potent immunosuppressant with a mechanism of action different from cyclosporine (CsA) or tacrolimus. Methods. In 11 European centers, first cadaveric renal allograft recipients were randomized to CsA (n=42) or sirolimus (n=41). Dosing of these agentswas concentration-controlled and open-labeled. All patients received corticosteroids and azathioprine. Results. At 12 months, graft survival (98% sirolimus vs. 90% CsA), patientsurvival (100% vs. 98%), and incidence of biopsy-confirmed acute rejection(41% vs. 38%) were similar, Serum creatinine was lower with sirolimus, significantly (P less than or equal to 0.05) so at 3 and 4 months, and serum uric acid and magnesium were normal. Laboratory abnormalities reported significantly more often with sirolimus included hypertriglyceridemia (51% vs. 12%), hypercholesterolemia (44% vs. 14%), thrombocytopenia (37% vs, 0%), leukopenia (39% vs. 14%), and, of lesser importance, increased liver enzymes and hypokalemia. These abnormalities improved 2 months after transplantationwhen the sirolimus target trough level was lowered from 30 to 15 ng/ml. Occurrence of cytomegalovirus was comparable (14% vs. 12%); incidences of herpes simplex (24% vs. 10%, P=0.08) and pneumonia (17% vs. 2%, P=0.03) were higher with sirolimus. No gingival hyperplasia was seen with sirolimus, tremor was rare, and hypertension was less frequent (17% vs. 33%), Two malignancies were observed with CsA and none with sirolimus. Conclusions. Results at 12 months suggest that sirolimus can be used as base therapy in the prophylaxis of acute renal transplant rejection, and has a safety profile that differs from CsA.

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Documento generato il 07/07/20 alle ore 11:41:49