Is everolimus useful in preventing allograft rejection and vasculopathy after heart transplant?
The main cause of illness and death after the first year of heart transplantation is vasculopathy of the cardiac allograft, probably initiated by early immunological and non-immunological endothelial damage. The incidence of multiple episodes of grade 3A rejection 6 months after primary heart transplantation was lower with everolimus (1.5 mg, 8.1% and 3 mg, 6.6%) than in the azathioprine group (14%). Allograft vasculopathy was less frequent with everolimus than azathioprine. A follow-up study is necessary to determine whether these effects translate into the important end points of reduced incidences of death, graft loss or a second transplantation.
Doggrell
Sheila A
SA
Doggrell Biomedical Communications, Auckland, New Zealand. s_doggrell@yahoo.com
D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000368:Aged; D001379:Azathioprine / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D004359:Drug Therapy, Combination; D000068338:Everolimus; D006084:Graft Rejection / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use*; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods
D000305:Adrenal Cortex Hormones; D008078:Cholesterol, LDL; D003524:Cyclosporins; D002784:Cholesterol; D000068338:Everolimus; D003404:Creatinine; D001379:Azathioprine; D020123:Sirolimus