Efficacy and Safety of Conversion from Twice-daily to Once-daily Tacrolimus in a Large Cohort of Stable Kidney Transplant Recipients
Por:
Guirado, L, Cantarell, C, Franco, A, Huertas, EG, Fructuoso, AS, Fernandez, A, Gentil, MA, Paul, J, Torregrossa, JV, Rodriguez, A, Alonso, A, Hernandez, D, Burgos, D, Jimenez, C, Jimeno, L, Lauzurica, R, Mazuecos, A, Osuna, A, Plumed, JS, Ruiz, JC, Zarraga, S
Publicada:
1 sep 2011
Resumen:
Prolonged-release tacrolimus was developed to provide a more convenient once-daily dosing that could improve patient adherence. We conducted a multicenter, prospective, observational, 12-month study to describe the efficacy, safety and patient preference of conversion from tacrolimus twice-daily to once-daily formulation in stable kidney transplant recipients in routine clinical practice. Conversion was made on a 1 mg : 1 mg basis (1 mg : 1.1 mg in patients with trough levels <6 ng/mL). The study included 1832 patients (mean age (+/- SD): 50.0 +/- 13.4 years; 62.7% male). After conversion, a modest reduction in tacrolimus trough levels, necessitating an increase in daily dose, was observed (mean changes at 12 months of -9.1% and + 1.24%, respectively; p < 0.0001). Mean glomerular filtration rate did not change significantly (56.5 +/- 19.7 mL/min at conversion vs. 55.7 +/- 20.6 mL/min at 12 months). Proteinuria, blood pressure, lipid, hepatic and glucose parameters remained stable. Eight patients (0.4%) had acute rejection and 34 patients (1.85%) discontinued treatment. Almost all patients (99.4%) preferred the once-daily formulation, because of less frequent dosing (66%) and improved adherence (34%). In conclusion, at similar doses to twice-daily tacrolimus, once-daily formulation provided stable renal function, a low acute rejection rate, and good tolerability in stable kidney transplant recipients in the routine clinical practice setting.
Filiaciones:
Guirado, L:
Fundacio Puigvert, Renal Transplant Unit, Barcelona, Spain
Cantarell, C:
Hosp Univ Vall Hebron, Dept Nephrol, Barcelona, Spain
Franco, A:
Hosp Generalde Alicante, Dept Nephrol, Alicante, Spain
Huertas, EG:
Hosp Univ Cent Asturias, Dept Nephrol, Oviedo, Spain
Fructuoso, AS:
Hosp Clin San Carlos, Dept Nephrol, Madrid, Spain
Fernandez, A:
Hosp Ramon & Cajal, Dept Nephrol, Madrid, Spain
Gentil, MA:
Hosp Virgen del Rocio, Clin Nephrol & Urol Unit, Seville, Spain
Paul, J:
Hosp Univ Miguel Servet, Dept Nephrol, Zaragoza, Spain
Torregrossa, JV:
Hosp Clin Barcelona, Renal Transplant Unit, Barcelona, Spain
Rodriguez, A:
Hosp Univ Canarias, Dept Nephrol, Santa Cruz De Tenerife, Spain
Hosp Reina Sofia, Dept Nephrol, Cordoba, Spain
Alonso, A:
Complejo Hosp A Coruna, Dept Nephrol, La Coruna, Spain
Hernandez, D:
Hosp Reg Univ Carlos Haya, Dept Nephrol, Malaga, Spain
Burgos, D:
Hosp Reg Univ Carlos Haya, Dept Nephrol, Malaga, Spain
Jimenez, C:
Hosp La Paz, Dept Nephrol, Madrid, Spain
Jimeno, L:
Hosp Virgen Arrixaca, Dept Nephrol, Murcia, Spain
Lauzurica, R:
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
Mazuecos, A:
Hosp Puerta del Mar, Dept Nephrol, Cadiz, Spain
Osuna, A:
Hosp Virgen de las Nieves, Dept Nephrol, Granada, Spain
Plumed, JS:
Hosp La Fe, Dept Nephrol, E-46009 Valencia, Spain
Ruiz, JC:
Hosp Marques de Valdecilla, Dept Nephrol, Santander, Spain
Zarraga, S:
Hosp Cruces, Dept Nephrol, Bilbao, Spain
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