Long-Term Follow-Up of De Novo Use of mTOR and Calcineurin Inhibitors After Kidney Transplantation

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dc.citation.issue1
dc.citation.volume38
dc.contributor.authorde Paula, Mayara Ivani [UNIFESP]
dc.contributor.authorMedina-Pestana, Jose Osmar [UNIFESP]
dc.contributor.authorFerreira, Alexandra Nicolau [UNIFESP]
dc.contributor.authorCristelli, Marina Pontello [UNIFESP]
dc.contributor.authorFranco, Marcello Fabiano [UNIFESP]
dc.contributor.authorAguiar, Wilson Ferreira [UNIFESP]
dc.contributor.authorTedesco-Silva, Helio [UNIFESP]
dc.contributor.authorFelipe, Claudia Rosso [UNIFESP]
dc.coveragePhiladelphia
dc.date.accessioned2020-10-30T18:46:33Z
dc.date.available2020-10-30T18:46:33Z
dc.date.issued2016
dc.description.abstractBackground:Long-term efficacy and safety of de novo use of the mammalian target of rapamycin inhibitors (mTORi) have been evaluated primarily using registry data.Methods:This was a pooled retrospective analysis of data obtained from 10 prospective randomized trials in de novo kidney transplant recipients (n = 581) receiving calcineurin inhibitors (CNIs) combined with sirolimus (n = 329), everolimus (n = 128), or antimetabolites (n = 124).Results:There were no differences in patient (84.5 versus 80.9 versus 89.7%, P = 0.996), graft (65.4 versus 59.5 versus 73.1%, P = 0.868), and biopsy-confirmed acute rejection-free (78.1 versus 77.3 versus 79.0%, P = 0.976) survivals, respectively. The incidence of cytomegalovirus infection was lower (6 versus 3 versus 11%, P = 0.024) but treatment discontinuation was higher among patients receiving mTORi (66.0 versus 47.7 versus 31.5%, P < 0.001), respectively. At 5 years, median estimated glomerular filtration rate (49.6 versus 43.9 versus 53.2 mL/min, P = 0.006) was lower and the proportion of patients with proteinuria (53 versus 40 versus 23%, P < 0.001) was higher among patients receiving mTORi, respectively.Conclusions:The efficacy of de novo use of mTORi is comparable with that of antimetabolites in kidney transplant recipients receiving calcineurin inhibitor. Apart from the lower cytomegalovirus infection rate, the safety profile is unfavorable, showing higher treatment discontinuation rates and higher incidence of proteinuria.en
dc.description.affiliationUniv Fed Sao Paulo, Div Nephrol, Hosp Rim, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Pathol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Div Urol, Hosp Rim, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Nephrol, Hosp Rim, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Pathol, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Urol, Hosp Rim, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent22-31
dc.identifierhttps://doi.org/10.1097/FTD.0000000000000227
dc.identifier.citationTherapeutic Drug Monitoring. Philadelphia, v. 38, n. 1, p. 22-31, 2016.
dc.identifier.doi10.1097/FTD.0000000000000227
dc.identifier.issn0163-4356
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/58509
dc.identifier.wosWOS:000368802800004
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofTherapeutic Drug Monitoring
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectsirolimusen
dc.subjecteverolimusen
dc.subjectsafetyen
dc.subjecttolerabilityen
dc.subjectefficacyen
dc.titleLong-Term Follow-Up of De Novo Use of mTOR and Calcineurin Inhibitors After Kidney Transplantationen
dc.typeinfo:eu-repo/semantics/article
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