Protocol conversion from a calcineurin inhibitor based therapy to sirolimus.
Small late-conversion studies found an impressive glomerular filtration rate (GFR) increase 1 year after conversion from calcineurin inhibitor (CNI) to sirolimus (SRL). This effect could not be detected in the considerably larger CONVERT study, which found a lower rate of malignancies in the SRL group. In the spare the nephron trial patients converted to SRL exhibited a mean measured GFR of 68 mL/min at 1 year compared with 60 mL/min from CNI patients (P<0.05). Accordingly, the CONCEPT study which randomized patients to SRL conversion 3 months after transplantation reported a significant higher GFR in the SRL patients at 1 year. These trials showed that conversion of stable renal transplant recipients from CNI to SRL is safe.
Oberbauer
Rainer
R
Department of Nephrology, KH Elisabethinen, Linz and Medical University of Vienna and Austrian Dialysis and Transplant Registry, Vienna, Austria. rainer.oberbauer@meduniwien.ac.at
D001706:Biopsy; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology / Q000502:physiology; D009369:Neoplasms / Q000139:chemically induced / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012449:Safety; D020123:Sirolimus / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus