title: Evaluation of the efficacy and safety of the conversion from a calcineurin inhibitor to an everolimus-based therapy in maintenance renal transplant patients.
abstract: Everolimus has recently been introduced into clinical practice with promising perspectives due to its efficacy, lack of nephrotoxicity, and antitumor effects. Experience in clinical trials associated with low-dose cyclosporine showed good results, but there is almost no experience in calcineurin inhibitor (CNI) elimination learning it as the primary immunosuppressant. We describe our experience in a series of 78 stable renal transplant patients who were switched to Everolimus with complete and quick elimination of the CNI: the procedure of conversion, pharmacokinetic results after conversion, evolution of renal parameters (renal function, proteinuria, and others), and safety data (acute rejection and adverse events). An initial dose of 3 mg/d was adequate to obtain the recommended trough levels between 5 and 10 ng/mL. Our results demonstrated that conversion to Everolimus was a simple, safe procedure that must be considered in patients CNI toxicity, especially those with malignant neoplasms and progressive deterioration of renal function due to chronic allograft nephropathy.
authors: Nephrology Department, Hospital Clinico San Carlos, Madrid, Spain.
authors: A
authors: A
authors: Sánchez Fructuoso
authors: J C
authors: JC
authors: Ruiz San Millán
authors: N
authors: N
authors: Calvo
authors: E
authors: E
authors: Rodrigo
authors: M A
authors: MA
authors: Moreno
authors: J
authors: J
authors: Cotorruelo
authors: J
authors: J
authors: Conesa
authors: C
authors: C
authors: Gómez-Alamillo
authors: M
authors: M
authors: Arias
authors: A
authors: A
authors: Barrientos
mesh_terms: D065095:Calcineurin Inhibitors; D004305:Dose-Response Relationship, Drug; D000068338:Everolimus; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology*; D012449:Safety; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus