title: Clinical advantages including medication adherence with conversion to once-daily advagraf and sirolimus combination in stable kidney recipients.
abstract: OBJECTIVE
  For the past decades, the long-term results of renal allograft unchanged despite the development of immunology and drugs. The long-term use of a calcineurin-inhibitor (CNI) and medication nonadherence have become important issues affecting long-term results. The combination of the once-daily advagraf and sirolimus was proposed as a good alternative with such reasons. The purpose of this study was the analysis of the clinical advantages of oncedaily advagraf and sirolimus combination by decreasing the use of CNI and improving medication adherence in stable kidney recipients.
  
  
  METHODS
  In this study, 34 patients who switched from their present medication to a once-daily advagraf and sirolimus combination at Korea University Anam Hospital from September 2011 to March 2013 were retrospectively reviewed for 24 months. Laboratory findings, clinical findings, and medication adherence were reviewed and analyzed.
  
  
  RESULTS
  After conversion to the new regimen, renal function was slightly improved at 3 months, as evidenced by creatinine levels (p = 0.024) and eGFR (p < 0.001). Lipid profiles deteriorated throughout the study period. Serum fast glucose level and proteinuria increased significantly at 12 months but recovered at 24 months. On the Morisky-Green test (MGT) for medication adherence, there were adherent improvements of 23.33% after 12 months and 16.66% after 24 months.
  
  
  CONCLUSIONS
  The once-daily advagraf and sirolimus combination can be a safe and effective regimen in stable kidney recipients as the study shows that the regimen improves renal function and medication adherence with controllable adverse effects of sirolimus.
authors.forename: Heungman
authors.initials: H
authors.lastname: Jun
authors.forename: Myung Gyu
authors.initials: MG
authors.lastname: Kim
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: Jung
mesh_terms: D000328:Adult; D065095:Calcineurin Inhibitors / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D016559:Tacrolimus / Q000008:administration & dosage*
chemical_list: D065095:Calcineurin Inhibitors; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus