Extended release once a day tacrolimus

Singh, Neeraj; Visger, Jon Von; Zachariah, Mareena

doi:10.1097/mot.0000000000000251

Cited by 9 publications

(3 citation statements)

References 42 publications

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“…It was found that based on the result of Scr, renal function was improved after tacrolimus conversion from immediate-to extended-release formulation in renal transplant patients with a follow-up duration ≥48 weeks but not in patients with a follow-up duration <48 weeks. The possible interpretation would be that, as discussed previously, extended-release tacrolimus was in a once-daily formulation procedure, which increased medication adherence (Hatakeyama et al, 2012;Singh et al, 2015;Oh et al, 2020;Verma et al, 2023); therefore, the long-term effect of conversion to extendedrelease tacrolimus on improving the renal function in renal transplant patients was obvious. Further subgroup analysis discovered that in patients with the tacrolimus dose after conversion ≤4.0 mg/d and patients with the tacrolimus blood trough level after conversion >6.0 ng/mL, the renal function seemed to be improved.…”

Section: Discussionmentioning

confidence: 91%

“…The potential reasons would be as follows ( Goldfarb, 2021 ): an extended-release tacrolimus formulation might have a flat pharmacokinetic profile, such as higher bioavailability, less fluctuation between trough and peak exposures, and a delayed peak concentration; thus, it might have a better effect on inhibiting antibody-mediated rejection, thus improving the renal function ( Garnock-Jones, 2015 ; Oberbauer et al, 2020 ; Hart et al, 2021a ). An extended-release tacrolimus formulation only needs to be taken once daily, which might increase medication adherence, and then improved the renal function ( Singh et al, 2015 ; Oberbauer et al, 2020 ). Another finding of this meta-analysis should also be noticed.…”

Section: Discussionmentioning

confidence: 99%

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The effect of tacrolimus conversion from immediate- to extended-release formulation on renal function in renal transplant patients: a meta-analysis

Chao,

Jia,

Zhu

et al. 2023

Front. Pharmacol.

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Objective: Tacrolimus formulation affects the outcomes of a renal transplant, while the effect of its immediate- to extended-release conversion remains controversial. This meta-analysis aimed to compare the renal function before and after tacrolimus immediate- to extended-release conversion in renal transplant patients.Methods: PubMed, Cochrane, Embase, CNKI, CQVIP, and Wanfang databases were searched for articles regarding the effect of tacrolimus conversion from immediate- to extended-release formulation on renal function in renal transplant patients. The data on serum creatinine (Scr) or the estimated glomerular filtration rate (eGFR) before and after conversion were extracted and analyzed.Results: Ten studies with 743 renal transplant patients were included. Scr was reduced after conversion versus before conversion [mean difference (MD) (95% confidence interval (CI)): -8.00 (−14.33; −1.66) μmol/L, p = 0.01]. However, eGFR only showed an increased trend after conversion versus before conversion (MD (95% CI): 2.21 (−1.62, 6.03) mL/min/1.73 m2, p = 0.26) but without statistical significance. Furthermore, in patients with a follow-up duration ≥48 weeks, Scr was decreased after conversion versus before conversion (p = 0.005), but eGFR remained unchanged (p = 0.68). However, in patients with a follow-up duration <48 weeks, both Scr (p = 0.36) and eGFR (p = 0.24) were not different before conversion versus after conversion. Moreover, publication bias risk was low, and robustness assessed by sensitivity analysis was generally good.Conclusion: This meta-analysis favors studies indicating that the conversion of tacrolimus from an immediate-release to an extended-release formulation could improve the kidney function to some extent in renal transplant patients, and this advancement may be related to the administration period.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The effect of tacrolimus conversion from immediate- to extended-release formulation on renal function in renal transplant patients: a meta-analysis

Chao,

Jia,

Zhu

et al. 2023

Front. Pharmacol.

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“…Here we will provide a brief overview of immunosuppressive compounds, so as to provide background for nanoparticle discussions. For more detailed information of immunosuppressive drug regimens and mechanism of action, see [reviews 2–9 ] and Table 1.…”

Section: Introductionmentioning

confidence: 99%

Nanotechnological Approaches to Immunosuppression and Tolerance Induction

et al. 2017

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Purpose of review Several preclinical studies have engineered nanoparticles for immune regulation, and have shown promising results in the fields of autoimmunity and cancer. In solid organ transplantation, the use of nanoparticle-based immune regulation has only just begun to emerge but holds significant promise for the improvement of our current standard of care immunosuppressive regimens. In this review, we will shed light on the current status of nanoparticle-engineered immunotherapeutics, and the potential application of these technologies to the field of organ transplantation. Further we discuss different strategies for delivery and potential cellular targeting moieties that could be utilized to obviate the need for high dose systemic immunosuppressive regimens. Recent Findings Recent studies have shown the potential of immunosuppressive laden nanoparticles to increase bioavailability, drug release, and specifically target immune cell compartments as methods to provide recipient immunosuppressive sparing strategies. Summary Nanoparticle centered immunosuppressive strategies hold the potential to usher in a new era in transplant recipient management and could hold the key to minimizing off-target effects of immunosuppressants, along with prolonging transplant survival.

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Adherence in pediatric kidney transplant recipients: solutions for the system

et al. 2017

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Non-adherence remains a significant problem among pediatric (and adult) renal transplant recipients. Non-adherence among solid organ transplant recipients results in US$15-100 million annual costs. Estimates of non-adherence range from 30 to 70% among pediatric patients. Research demonstrates that a 10% decrement in adherence is associated with 8% higher hazard of graft failure and mortality. Focus has begun to shift from patient factors that impact adherence to the contributing healthcare and systems factors. The purpose of this review is to describe problems within the systems implicated in non-adherence and potential solutions that may be related to positive adherence outcomes. Systems issues include insurance and legal regulations, provider and care team barriers to optimal care, and difficulties with transitioning to adult care. Potential solutions include recognition of how systems can work together to improve patient outcomes through improvements in insurance programs, a multi-disciplinary care team approach, evidence-based medical management, pharmacy-based applications and interventions to simplify medication regimens, improved transition protocols, and telehealth/technology-based multi-component interventions. However, there remains a significant lack of reliability in the application of these potential solutions to systems issues that impact patient adherence. Future efforts should accordingly focus on these efforts, likely by leveraging quality improvement and related principles, and on the investigation of the efficacy of these interventions to improve adherence and graft outcomes.

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Extended release once a day tacrolimus

Abstract: Although extended release tacrolimus shows promise in improving patient adherence to transplant medication therapy, further studies are needed to confirm improved compliance and to assess long-term safety and efficacy.

Cited by 9 publications

References 42 publications

The effect of tacrolimus conversion from immediate- to extended-release formulation on renal function in renal transplant patients: a meta-analysis

The effect of tacrolimus conversion from immediate- to extended-release formulation on renal function in renal transplant patients: a meta-analysis

Nanotechnological Approaches to Immunosuppression and Tolerance Induction

Adherence in pediatric kidney transplant recipients: solutions for the system

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