[Proliferation signal inhibitors: what therapeutic protocols are followed in 2009?].
Proliferation signal inhibitors (PSI) have been used in France for kidney transplants for some ten years. They provide a certain number of long-term benefits for kidney function in transplant patients due to their anti-proliferation and anti-tumour properties and absence of nephrotoxicity. Their use has been evaluated in therapeutic regimens aimed at reducing the nephrotoxicity associated with calcineurin inhibitors (CNI). Strategies based on minimizing the use of CNIs and therapy switches between 3 and 6 months have shown promising results, especially in terms of prevention of deterioration of kidney function. The best time to make the switch has not yet been defined with certainty, but predictors of success, preservation of good kidney function and absence of proteinuria have been established. Aside from cases of demonstrated CNI toxicity, a history or onset of de novo cancer is a situation in which this type of regimen can be considered.
CHU Nancy, Hôpital d'adultes de Brabois, Service de néphrologie, Avenue de Bourgogne, Vandoeuvre Les Nancy, France. m.ladriere@chu-nancy.fr
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D065095:Calcineurin Inhibitors; D002985:Clinical Protocols; D000068338:Everolimus; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus