Temporal Trends in the Use of Proliferation Signal Inhibitors in Maintenance Heart Transplantation: A Spanish Multicenter Study
Por:
Gonzalez-Vilchez, F, Almenar, L, Arizon, JM, Mirabet, S, Delgado, JF, de Molina, BD, Gomez, M, Paniagua, MJ, Perez-Villa, F, Roig, E, de Prada, JAV
Publicada:
1 oct 2010
Resumen:
Proliferation signal inhibitors (PSI; sirolimus, everolimus) are being increasingly used in heart transplantation. We performed an observational, retrospective, multicenter study in 9 Spanish centers seeking to describe the clinical context in which a PSI was used among maintenance heart recipients and its evolution over time. We collected a cohort of 548 patients in whom a PSI was prescribed from October 2001 to March 2009. The group was divided into 3 time periods. The use of PSI steeply increased in the 2005-2006 period, remaining stable thereafter. There were no significant differences over time with regard to age, gender, or time from transplantation to the introduction of the PSI. Everolimus usage overtook sirolimus from 2005 on; currently, >90% of the subjects with PSI indications are prescribed everolimus. Compared with earlier periods, patients in the more recent period (October 2006-March 2009) showed less vascular graft disease and better basal renal function, irrespective of the primary indication for the PSI prescription. Also, skin cancer overtook solid cancer as the main type of neoplasm in patients for whom malignancy was the primary indication for the use of the PSI. The actuarial incidence of PSI withdrawal owing to adverse effects did not change significantly over time.
Filiaciones:
Gonzalez-Vilchez, F:
Hosp Univ Marques de Valdecilla, Santander, Spain
Almenar, L:
Hosp Univ La Fe, Valencia, Spain
Arizon, JM:
Hosp Univ Reina Sofia, Cordoba, Spain
Mirabet, S:
Hosp Univ Sant Creu & Sant Pau, Barcelona, Spain
Delgado, JF:
Hosp Univ Doce de Octubre, Madrid, Spain
de Molina, BD:
Hosp Univ Cent Asturias, Oviedo, Spain
Gomez, M:
Hosp Univ Puerta de Hierro, Madrid, Spain
Paniagua, MJ:
Hosp Univ A Coruna, La Coruna, Spain
Perez-Villa, F:
Hosp Clin Univ Barcelona, Barcelona, Spain
Roig, E:
Hosp Univ Sant Creu & Sant Pau, Barcelona, Spain
de Prada, JAV:
Hosp Univ Marques de Valdecilla, Santander, Spain
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