Conversion of stable kidney transplant recipients from a twice-daily prograf to a once-daily tacrolimus formulation: a short-term study on its effects on glucose metabolism.
BACKGROUND
The adverse effects of tacrolimus are known to play major roles in posttransplantation diabetes mellitus (PTDM). In the present study, we investigated the effects of conversion from a twice-daily (Tac BID) to a once-daily prolonged release of tacrolimus formulation (Tac OD) on glucose metabolism in stable kidney transplant recipients.


METHODS
In this prospective study, 26 patients converted from Tac BID to the same milligram-milligram daily dose of Tac OD were examined for the effects on renal function, drug trough levels, and glucose metabolism over a 4-week period.


RESULTS
Conversion from Tac BID to Tac OD on a 1:1 mg basis resulted in a significant decrease in tacrolimus trough levels, but no significant changes in renal function. At 4 weeks after conversion, a homeostasis model assessment of β-cell function, and hemoglobin A1c (HbA1c) decreased significantly.


CONCLUSIONS
This study demonstrated a significant reduction in tacrolimus trough levels after switching from Tac BID to Tac OD, which increased insulin secretion and decreased HbA1c, suggesting that it may decrease the frequency of PTDM among stable renal transplant recipients.
Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan. m9492120@msic.med.osaka-cu.ac.jp
J
J
Uchida
N
N
Kuwabara
Y
Y
Machida
T
T
Iwai
T
T
Naganuma
N
N
Kumada
T
T
Nakatani
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D003692:Delayed-Action Preparations; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006442:Glycated Hemoglobin / Q000378:metabolism; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D007328:Insulin / Q000097:blood; D050417:Insulin-Secreting Cells / Q000187:drug effects* / Q000378:metabolism; D007564:Japan; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D003404:Creatinine; D003692:Delayed-Action Preparations; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D007328:Insulin; D016559:Tacrolimus; C517652:hemoglobin A1c protein, human