FTY720, a novel immunomodulator: efficacy and safety results from the first phase 2A study in de novo renal transplantation.
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FTY720, a novel immunomodulator: efficacy and safety results from the first phase 2A study in de novo renal transplantation. / Tedesco-Silva, Helio; Mourad, Georges; Kahan, Barry D; Boira, Josep Grinyo; Weimar, Willem; Mulgaonkar, Shamkant; Nashan, Björn; Madsen, Soren; Charpentier, Bernard; Pellet, Pascale; Vanrenterghem, Yves.
In: TRANSPLANTATION, Vol. 77, No. 12, 12, 2004, p. 1826-1833.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - FTY720, a novel immunomodulator: efficacy and safety results from the first phase 2A study in de novo renal transplantation.
AU - Tedesco-Silva, Helio
AU - Mourad, Georges
AU - Kahan, Barry D
AU - Boira, Josep Grinyo
AU - Weimar, Willem
AU - Mulgaonkar, Shamkant
AU - Nashan, Björn
AU - Madsen, Soren
AU - Charpentier, Bernard
AU - Pellet, Pascale
AU - Vanrenterghem, Yves
PY - 2004
Y1 - 2004
N2 - BACKGROUND: FTY720 is the first of a new drug class: sphingosine-1-phosphate receptor agonist. Its effect relates to the modulation of lymphocytes trafficking from blood and peripheral tissues to lymph nodes. This is the first study to evaluate the efficacy and safety of FTY720 in de novo renal transplantation. METHODS: This phase 2a, multicenter, open-label, dose-finding study compared FTY720 (0.25, 0.5, 1.0, or 2.5 mg) with mycophenolate mofetil (MMF), in combination with cyclosporine and corticosteroids. Patients (n=208) received FTY720 (n=167) or MMF (n=41) for 3 months followed by a 3-month follow-up. RESULTS: The incidence of biopsy-confirmed acute rejection at month 3 was 23.3%, 34.9%, 17.5%, and 9.8%, respectively, with FTY720 at doses of 0.25, 0.5, 1.0, and 2.5 mg, versus 17.1% with MMF. The incidence for the composite endpoint (biopsy-confirmed acute rejection, graft loss, or death) was lowest with FTY720 at a dose of 2.5 mg at month 3 (14.6%) compared with FTY720 at doses of 0.25 mg (25.6%), 0.5 mg (34.9%), and 1.0 mg (17.5%), and MMF (19.5%). Safety was comparable between FTY720 and MMF group. The main difference in tolerability was a mild and transient reduction in heart rate. A decrease in peripheral lymphocytes occurred in patients receiving FTY720, as expected from the mode of action, and this was reversible after treatment cessation. CONCLUSIONS: FTY720 at 2.5 mg was found to be as effective as MMF in combination with cyclosporine for the prevention of acute rejection after renal transplantation. FTY720 was well tolerated and not associated with the side effects commonly observed with immunosuppressant therapies.
AB - BACKGROUND: FTY720 is the first of a new drug class: sphingosine-1-phosphate receptor agonist. Its effect relates to the modulation of lymphocytes trafficking from blood and peripheral tissues to lymph nodes. This is the first study to evaluate the efficacy and safety of FTY720 in de novo renal transplantation. METHODS: This phase 2a, multicenter, open-label, dose-finding study compared FTY720 (0.25, 0.5, 1.0, or 2.5 mg) with mycophenolate mofetil (MMF), in combination with cyclosporine and corticosteroids. Patients (n=208) received FTY720 (n=167) or MMF (n=41) for 3 months followed by a 3-month follow-up. RESULTS: The incidence of biopsy-confirmed acute rejection at month 3 was 23.3%, 34.9%, 17.5%, and 9.8%, respectively, with FTY720 at doses of 0.25, 0.5, 1.0, and 2.5 mg, versus 17.1% with MMF. The incidence for the composite endpoint (biopsy-confirmed acute rejection, graft loss, or death) was lowest with FTY720 at a dose of 2.5 mg at month 3 (14.6%) compared with FTY720 at doses of 0.25 mg (25.6%), 0.5 mg (34.9%), and 1.0 mg (17.5%), and MMF (19.5%). Safety was comparable between FTY720 and MMF group. The main difference in tolerability was a mild and transient reduction in heart rate. A decrease in peripheral lymphocytes occurred in patients receiving FTY720, as expected from the mode of action, and this was reversible after treatment cessation. CONCLUSIONS: FTY720 at 2.5 mg was found to be as effective as MMF in combination with cyclosporine for the prevention of acute rejection after renal transplantation. FTY720 was well tolerated and not associated with the side effects commonly observed with immunosuppressant therapies.
M3 - SCORING: Zeitschriftenaufsatz
VL - 77
SP - 1826
EP - 1833
JO - TRANSPLANTATION
JF - TRANSPLANTATION
SN - 0041-1337
IS - 12
M1 - 12
ER -