Use of Everolimus in Renal Transplant Recipients: Data From a National Registry

Cicora, Federico; Massari, P.; Acosta, F.; Petrone, H.; Cambariere, R.; González, Irati Tapia; Imperiali, Nora; López, Ferran Campillo i; Otero, A.; Roberti, Javier

doi:10.1016/j.transproceed.2014.07.007

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…[18,19] EVR in combination with MMF has shown promising renal outcomes after liver, heart, and kidney transplantation. [20–22] Moreover, mTOR inhibitors have been shown to prevent tumors and even to reduce metastatic tumor growth by angiogenesis.…”

Section: Introductionmentioning

confidence: 99%

Influence of cyclosporine and everolimus on the main mycophenolate mofetil pharmacokinetic parameters

et al. 2017

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The objective of the present study was to assess the effect of cyclosporine (CsA) on the pharmacokinetic parameters of mycophenolic acid (MPA), an active mycophenolate mofetil (MMF) metabolite, and to compare with the effect of everolimus (EVR).Anonymized medical records of 404 kidney recipients were reviewed. The main MPA pharmacokinetic parameters (AUC(0–12) and Cmax) were evaluated.The patients treated with a higher mean dose of CsA displayed higher MPA AUC(0–12) exposure in the low-dose MMF group (1000 mg/day) (40.50 ± 10.97 vs 28.08 ± 11.03 h mg/L; rs = 0.497, P < 0.05), medium-dose MMF group (2000 mg/day) (43.00 ± 6.27 vs 28.85 ± 11.08 h mg/L; rs = 0.437, P < 0.01), and high-dose MMF group (3000 mg/day) (56.75 ± 16.78 vs 36.20 ± 3.70 h mg/L; rs = 0.608, P < 0.05).A positive correlation was also observed between the mean CsA dose and the MPA Cmax in the low-dose MMF group (Cmax 22.83 ± 10.82 vs 12.08 ± 5.59 mg/L; rs = 0.507, P < 0.05) and in the medium-dose MMF group (22.77 ± 8.86 vs 13.00 ± 6.82 mg/L; rs = 0.414, P < 0.01).The comparative analysis between 2 treatment arms (MMF + CsA and MMF + EVR) showed that MPA AUC(0–12) exposure was by 43% higher in the patients treated with a medium dose of MMF and EVR than in the patients treated with a medium dose of MMF and CsA.The data of the present study suggest a possible CsA versus EVR influence on MMF pharmacokinetics. Study results show that CsA has an impact on the main MPA pharmacokinetic parameters (AUC(0–12) and Cmax) in a CsA dose-related manner, while EVR mildly influence or does not affect MPA pharmacokinetic parameters. Low-dose CsA (lower than 180 mg/day) reduces MPA AUC(0–12) exposure under the therapeutic window and may lead to ineffective therapy, while a high-dose CsA (>240 mg/day) is related to greater than 10 mg/L MPA Cmax and increases the likelihood of adverse events.

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Section: Introductionmentioning

confidence: 99%

Influence of cyclosporine and everolimus on the main mycophenolate mofetil pharmacokinetic parameters

et al. 2017

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“…In a previous study, recipients who started treatment with EVR within 12 months after transplantation showed an improvement in the eGFR at 12 months compared to the eGFR at baseline. 16 It is known that in desensitized patients, surgical complications, especially wound healing complications, are more common. 10,17,18 If recipients start treatment with EVR before transplantation and immediately after transplantation, wound healing complications might become a problem.…”

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confidence: 99%