Corticosteroid elimination: the Cincinnati experience.
Elimination of corticosteroid-related morbidity has been a goal of transplant clinicians from the earliest days of renal transplantation more than 50 years ago. Over the past decade, this goal has begun to be realized. Herein, we describe our efforts to eliminate corticosteroid therapy from maintenance immunosuppression-efforts that have spanned 15 years and have included design and conduct of five multicenter trials and over ten single center trials with over 650 patients at the University of Cincinnati. These efforts have led to a near complete elimination of corticosteroid-related morbidity, and, importantly, a more precise definition of the risk/benefit assessments of corticosteroid withdrawal in individual patient populations, which has allowed individualization and tailoring of corticosteroid-free immunosuppression.
Woodle
E Steve
ES
University of Cincinnati, the Christ Hospital, Cincinnati, Ohio, USA.
Alloway
Rita
R
Rike
Adele
A
Roy-Chaudhury
Prabir
P
Tevar
Amit
A
Susskind
Brian
B
Everly
Jason
J
Mogilishetty
Gautham
G
Brailey
Paul
P
Govil
Amit
A
Rudich
Steve
S
First
M Roy
MR
Alexander
J Wesley
JW
Munda
Rino
R
Cardi
Michael
M
Arend
Lois
L
D000305:Adrenal Cortex Hormones; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009017:Morbidity; D015337:Multicenter Studies as Topic; D009820:Ohio / Q000453:epidemiology; D016377:Organ Transplantation; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents