Impact of long-term therapy with FTY720 or mycophenolate mofetil on cardiac conduction and rhythm in stable adult renal transplant patients.
The novel immunomodulator FTY720 has been associated with a mild reduction in heart rate (HR) in clinical trials. A total of 421 patients (FTY720, n=94; mycophenolate mofetil [MMF], n=327) underwent 2-day electrocardiogram and 24-h Holter monitoring. Patients had been maintained on cyclosporine plus MMF or FTY720 (2.5 mg and 5.0 mg) for > or =12 months. No significant differences in mean hourly heart rate (HR) over 24 hrs were noted between groups. Bradycardia (HR 35-50 bpm) and sustained bradycardia (HR <50 bpm for >1 min) were more common with MMF than FTY720 (53% vs. 37% and 34% vs. 21%, respectively). Electrocardiogram parameters did not differ significantly between FTY720 and MMF groups, or between FTY720 groups, supporting the absence of a dose-dependent effect. The absence of any clinically significant effect of FTY720 on cardiac rhythm demonstrates that the reduction in HR seen after the first dose does not persist in the maintenance phase.
Oppenheimer
Federico
F
Hospital Clinico y Provincial de Barcelona, Barcelona, Spain. OPPEN@clinic.ub.es
Mulgaonkar
Shamkant
S
Ferguson
Ronald
R
Grinyó
Josep
J
Juarez
Federico
F
Ostrowski
Marek
M
Klinger
Marian
M
Walker
Rowan
R
Torres
Armando
A
Preiss
Ralph
R
Cremer
Malika
M
Jardine
Alan
A
D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000328:Adult; D005260:Female; D000068876:Fingolimod Hydrochloride; D006329:Heart Conduction System / Q000187:drug effects / Q000276:immunology*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011409:Propylene Glycols / Q000627:therapeutic use*; D013110:Sphingosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D018674:Adrenergic Antagonists; D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D000068876:Fingolimod Hydrochloride; D009173:Mycophenolic Acid; D013110:Sphingosine