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Reduced exposure to calcineurin inhibitors in renal transplantation.

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Reduced exposure to calcineurin inhibitors in renal transplantation. / Ekberg, Henrik; Tedesco-Silva, Helio; Demirbas, Alper; Vítko, Stefan; Nashan, Björn; Gürkan, Alp; Margreiter, Raimund; Hugo, Christian; Grinyó, Josep M; Frei, Ulrich; Vanrenterghem, Yves; Daloze, Pierre; Halloran, Philip F.

in: NEW ENGL J MED, Jahrgang 357, Nr. 25, 25, 2007, S. 2562-2575.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Ekberg, H, Tedesco-Silva, H, Demirbas, A, Vítko, S, Nashan, B, Gürkan, A, Margreiter, R, Hugo, C, Grinyó, JM, Frei, U, Vanrenterghem, Y, Daloze, P & Halloran, PF 2007, 'Reduced exposure to calcineurin inhibitors in renal transplantation.', NEW ENGL J MED, Jg. 357, Nr. 25, 25, S. 2562-2575. <http://www.ncbi.nlm.nih.gov/pubmed/18094377?dopt=Citation>

APA

Ekberg, H., Tedesco-Silva, H., Demirbas, A., Vítko, S., Nashan, B., Gürkan, A., Margreiter, R., Hugo, C., Grinyó, J. M., Frei, U., Vanrenterghem, Y., Daloze, P., & Halloran, P. F. (2007). Reduced exposure to calcineurin inhibitors in renal transplantation. NEW ENGL J MED, 357(25), 2562-2575. [25]. http://www.ncbi.nlm.nih.gov/pubmed/18094377?dopt=Citation

Vancouver

Ekberg H, Tedesco-Silva H, Demirbas A, Vítko S, Nashan B, Gürkan A et al. Reduced exposure to calcineurin inhibitors in renal transplantation. NEW ENGL J MED. 2007;357(25):2562-2575. 25.

Bibtex

@article{e78f1ecfc48f46d1846213df4beb4b55,
title = "Reduced exposure to calcineurin inhibitors in renal transplantation.",
abstract = "BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. RESULTS: The mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). CONCLUSIONS: A regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. (ClinicalTrials.gov number, NCT00231764 [ClinicalTrials.gov].).",
author = "Henrik Ekberg and Helio Tedesco-Silva and Alper Demirbas and Stefan V{\'i}tko and Bj{\"o}rn Nashan and Alp G{\"u}rkan and Raimund Margreiter and Christian Hugo and Griny{\'o}, {Josep M} and Ulrich Frei and Yves Vanrenterghem and Pierre Daloze and Halloran, {Philip F}",
year = "2007",
language = "Deutsch",
volume = "357",
pages = "2562--2575",
journal = "NEW ENGL J MED",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "25",

}

RIS

TY - JOUR

T1 - Reduced exposure to calcineurin inhibitors in renal transplantation.

AU - Ekberg, Henrik

AU - Tedesco-Silva, Helio

AU - Demirbas, Alper

AU - Vítko, Stefan

AU - Nashan, Björn

AU - Gürkan, Alp

AU - Margreiter, Raimund

AU - Hugo, Christian

AU - Grinyó, Josep M

AU - Frei, Ulrich

AU - Vanrenterghem, Yves

AU - Daloze, Pierre

AU - Halloran, Philip F

PY - 2007

Y1 - 2007

N2 - BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. RESULTS: The mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). CONCLUSIONS: A regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. (ClinicalTrials.gov number, NCT00231764 [ClinicalTrials.gov].).

AB - BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. RESULTS: The mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). CONCLUSIONS: A regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. (ClinicalTrials.gov number, NCT00231764 [ClinicalTrials.gov].).

M3 - SCORING: Zeitschriftenaufsatz

VL - 357

SP - 2562

EP - 2575

JO - NEW ENGL J MED

JF - NEW ENGL J MED

SN - 0028-4793

IS - 25

M1 - 25

ER -