title: A quality of life comparison in cyclosporine- and tacrolimus-treated renal transplant recipients across Canada.
abstract: BACKGROUND
  Many Canadian renal transplant recipients receive either cyclosporine or tacrolimus as a long-term immunosuppressive agent. We investigated the effect of these drugs on quality of life (QoL) in Canadian transplant recipients.
  
  
  METHODS
  We included adult single-organ recipients undergoing a transplant between July 1997 and March 2005, whose graft function was =18 months, recruited across 13 Canadian sites including 5 transplant centers (TCs) and 8 satellite centers (SCs). Patients were stratified 3:1 by cyclosporine vs. tacrolimus based on calcineurin inhibitor(s) (CNIs) received at 6 months posttransplant and matched 1:1 by TC vs. SC. Physical (PCS) and mental component summary (MCS) scores measured by the SF-12 scale for cyclosporine- and tacrolimus-treated recipients were compared. Patient opinions about their perceived CNI-related side effects captured by categorical questions or a numerical Likert scale (1-10) were compared by chi-square test or ANOVA, respectively.
  
  
  RESULTS
  There were 231 participants (124 cyclosporine, 43 tacrolimus and 64 with dual experience) who responded to both questionnaires. Their SF-12-measured PCS and MCS scores were similar (PCS 42.0, 43.0 and 41.4, p=0.705; MCS 50.3, 47.8 and 47.1, p=0.115; respectively). However, patients receiving tacrolimus more strongly preferred to continue on this CNI than those receiving cyclosporine (67.4% vs. 44.4%, p=0.009), while more patients on cyclosporine wished to stop taking it (23.4 vs. 2.3%, p=0.004). Patient preference for CNI did not differ by center type.
  
  
  CONCLUSIONS
  QoL among Canadian renal transplant recipients receiving cyclosporine or tacrolimus is similar. Although Canadian recipients prefer tacrolimus, CNI type does not significantly affect their QoL.
authors.affiliation: Division of Nephrology, St. Michael's Hospital, University of Toronto, Toronto, Ontario - Canada. prasadr@smh.toronto.on.ca
authors.forename: G V Ramesh
authors.initials: GV
authors.lastname: Prasad
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Nash
authors.forename: Tammy
authors.initials: T
authors.lastname: Keough-Ryan
authors.forename: R Jean
authors.initials: RJ
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus