Efficacy and safety of everolimus treatment on liver transplant recipients: A meta‐analysis

Abstract

Background Everolimus is an effective immunosuppressant in organ transplantation without impaired renal function. The present study aimed to evaluate the efficacy and safety of everolimus therapy in liver transplant recipients. Materials and methods A systematic literature search was conducted to identify the eligible studies. The quality of the included studies was assessed. The outcomes of interest were biopsy‐proven acute rejection (BPAR), graft loss, death, renal function and adverse events. Results Eight trials involving 1570 participants were included. Compared to the standard exposure to calcineurin inhibitors (CNIs), the incidences of BPAR, graft loss and death were not increased in the everolimus combined with reduced CNIs group. The renal function was significantly improved after everolimus combined with reduced CNI therapy, and the glomerular filtration rate (GFR) was estimated to be elevated by 5.59 (95% CI: 2.17‐9.01, P = .001) as compared to the standard exposure to CNIs. The risk of any adverse event was increased by everolimus combined with reduced CNI therapy (RR = 1.22, 95% CI: 1.04‐1.42, P = .01) as compared to the standard exposure to CNIs. The likelihood of infection was not associated with the regimen. Any publication bias was not identified. Conclusions Although everolimus combined with reduced CNI therapy significantly improved the renal function in liver transplant recipients, it did not influence the incidence of BPAR, graft loss and death. This regimen might be associated with an increased risk of adverse events, which needs to be elucidated further.

Review of the Effectiveness of Various Adjuvant Therapies in Treating Mycobacterium tuberculosis

“…Everolimus is an immunosuppressant drug that has been approved for use in organ transplant recipients and in the treatment of various forms of cancer [ 28 , 29 ]. As an analog to rapamycin, it similarly inhibits the mammalian target of the rapamycin (mTOR) pathway.…”

The Effect of Immunosuppressive Drugs on MMPs Activity in The Walls of Blood Vessels - A Systematic Review

“…Contemporary immunosuppressive treatment constitutes of 4 groups of medications, such as: calcineurin inhibitors (CNIs) including cyclosporine A (CsA) and tacrolimus (TAC); inhibitors of the inosine monophosphate dehydrogenase (IMDH inhibitors) - the only agent from this group currently used in transplantation is mycophenalate mofetil (MMF); mTOR inhibitors (mTORIs), consisting of everolimus and glucocorticosteroids (GCS) 1 . On one hand, immunosuppressive agents lower immunity, on the other hand, they display toxic impact on the organs 2 - 7 . Furthermore, they can lead to pathological changes within the vessels 8 , 9 .…”

Hormonal (Im)Balance and Reproductive System’s Disorders in Transplant Recipients—A Review

“…Modern immunosuppressive agents constitute four groups of drugs. These are (i) calcineurin inhibitors including cyclosporin A and tacrolimus; (ii) mTOR inhibitors including sirolimus and its analog everolimus; (iii) inhibitors of the inosine monophosphate dehydrogenase consisting of mycophenolate mofetil, mycophenolate sodium and azathioprine; (iv) glucocorticoids, mostly prednisone [3,4]. Immunosuppressive drugs are widely applied to avoid graft rejection.…”