Controlled randomized study comparing the cardiovascular profile of everolimus with tacrolimus in renal transplantation
Por:
Cruzado, JM, Pascual, J, Sanchez-Fructuoso, A, Seron, D, Diaz, JM, Rengel, M, Oppenheimer, F, Hernandez, D, Paravisini, A, Saval, N, Morales, JM
Publicada:
1 dic 2016
Resumen:
Left ventricular hypertrophy (LVH) regression after kidney transplantation may be influenced by immunosuppression. In a 24-month open-label, multicenter, phase-IV study, 71 kidney allograft recipients without previous acute rejection, showing eGFR > 40 ml/min and proteinuria < 500 mg/day and between 6 months and 3 years post-transplantation, were randomized to receive everolimus (EVR) + mycophenolic acid (MPA) or were maintained on tacrolimus (TAC) + MPA. The aim was to assess whether the conversion to EVR could reduce left ventricular mass index (LVMi) at month-24. LVMi at month-24 decreased without differences between groups (TAC: 54.0 vs. 48.2 g/m(2.7); EVR: 53.4 vs. 49.4 g/m(2.7)). The LVH prevalence at baseline and month-24 was 59.4% and 40.6% in TAC group and 57.1% and 50.0% in EVR group. EVR conversion was associated with nearly disappearance of concentric LVH and concentric remodeling pattern. The procollagen type I N-terminal propeptide at month-24 showed greater reduction in EVR group (51.6 vs. 58.2 mg/l; P = 0.004). Conversion from TAC to EVR was associated with a significant improvement of eGFR (P = 0.0315, ANCOVA). Adverse events were similar between groups without rejection episode or graft loss. Conversion from TAC to EVR did not further reduce LVMi after 24 months, although its effect on concentric LVH deserves further investigation (NCT01169701).
Filiaciones:
Cruzado, JM:
Bellvitge Hosp, IDIBELL, Dept Nephrol, Barcelona, Spain
Pascual, J:
Hosp del Mar, Dept Nephrol, Barcelona, Spain
Sanchez-Fructuoso, A:
Hosp Clin San Carlos, Dept Nephrol, Madrid, Spain
Seron, D:
Hosp Valle De Hebron, Dept Nephrol, Barcelona, Spain
Diaz, JM:
Fundacio Puigvert, Dept Nephrol, Barcelona, Spain
Rengel, M:
Hosp Gregorio Maranon, Dept Nephrol, Madrid, Spain
Oppenheimer, F:
Hosp Clin Barcelona, Kidney Transplant Dept, Barcelona, Spain
Hernandez, D:
Hosp Carlos Haya, Dept Nephrol, Malaga, Spain
Paravisini, A:
Novartis Farmaceut, Dept Med, Barcelona, Spain
Saval, N:
Novartis Farmaceut, Dept Med, Barcelona, Spain
Morales, JM:
Hosp 12 Octubre, Dept Nephrol, Madrid, Spain
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