An open-label randomized trial of the safety and efficacy of sirolimus vs. azathioprine in living related renal allograft recipients receiving cyclosporine and prednisone combination

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dc.contributor.authorMachado, P. G.
dc.contributor.authorFelipe, C. R.
dc.contributor.authorHanzawa, N. M.
dc.contributor.authorPark, S. I.
dc.contributor.authorGarcia, R.
dc.contributor.authorAlfieri, F.
dc.contributor.authorFranco, M.
dc.contributor.authorSilva, H. T.
dc.contributor.authorMedina-Pestana, J. O.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionLabs Wyeth Brasil
dc.date.accessioned2016-01-24T12:34:18Z
dc.date.available2016-01-24T12:34:18Z
dc.date.issued2004-02-01
dc.description.abstractBackground: the ability of sirolimus (SRL), in combination with reduced exposure of cyclosporine, was investigated to prevent acute rejection and associated side effects.Methods: Between June 1999 and February 2000, 70 recipients of primary one-haplotype living-related donor renal allografts were randomized to receive SRL (2 mg/d) or azathioprine (AZA) (2 mg/kg/d) combined with cyclosporine and prednisone. the primary end-point was a composite of first occurrence of biopsy-confirmed acute rejection, graft loss, or death during the first 3 months after transplantation.Results: From week 4 to month 12, SRL patients received lower cyclosporine (week 4: 364 mg/d vs. 455 mg/d, p = 0.004; month 12: 195 mg/d vs. 255 mg/d, p = 0.038) doses and showed lower cyclosporine concentrations (week 4: 247 ng/mL vs. 309 ng/mL, p = 0.04; month 12: 143 ng/mL vs. 188 ng/mL, p = 0.045). Compared with AZA, SRL patients showed reduced 3-month primary end point (0% vs. 17.1%, p = 0.025), and reduced incidence of biopsy-confirmed acute rejection at 3 months (0% vs. 14.3%, p = 0.01) but not at 12 months (11.4% vs. 14.3%, NS). Mean creatinine at 12 months were not different (1.8 +/- 0.6 vs. 1.6 +/- 0.6, p = 0.23). Hyperlipidemia was the only adverse event more frequent among SRL patients (49% vs. 17%, p = 0.01). There were no differences in infections and no malignancies in both groups.Conclusions: the combination of 2 mg fixed doses of SRL, reduced cyclosporine exposure and prednisone was associated with a low incidence of acute rejection and did not result in significantly impaired graft function compared with patients receiving AZA, standard doses of cyclosporine and prednisone.en
dc.description.affiliationUniversidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Pathol, São Paulo, Brazil
dc.description.affiliationLabs Wyeth Brasil, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Hosp Rim & Hipertensao, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Pathol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent28-38
dc.identifierhttp://dx.doi.org/10.1111/j.1399-0012.2004.00113.x
dc.identifier.citationClinical Transplantation. Copenhagen: Blackwell Munksgaard, v. 18, n. 1, p. 28-38, 2004.
dc.identifier.doi10.1111/j.1399-0012.2004.00113.x
dc.identifier.issn0902-0063
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27629
dc.identifier.wosWOS:000188046700005
dc.language.isoeng
dc.publisherBlackwell Munksgaard
dc.relation.ispartofClinical Transplantation
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectacute rejectionen
dc.subjectclinical trialen
dc.subjectcyclosporineen
dc.subjectkidney transplantationen
dc.subjectsirolimusen
dc.titleAn open-label randomized trial of the safety and efficacy of sirolimus vs. azathioprine in living related renal allograft recipients receiving cyclosporine and prednisone combinationen
dc.typeinfo:eu-repo/semantics/article
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