Warning: Undefined variable $zfal in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Deprecated: str_replace(): Passing null to parameter #3 ($subject) of type array|string is deprecated in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 530
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 531
 
English Wikipedia
Nephropedia Template TP (
Twit Text
DeepDyve
Pubget Overpricing |  
lüll
Everolimus in clinical practice--renal transplantation Pascual JNephrol Dial Transplant 2006[Jul]; 21 Suppl 3 (ä): iii18-23Everolimus is a proliferation signal inhibitor (PSI)/mammalian target of rapamycin inhibitor that is structurally similar to sirolimus, but with a number of important pharmacokinetic differences, including a shorter half-life and time to steady state. In clinical trials, the efficacy of everolimus 1.5 mg/day and 3.0 mg/day combined with ciclosporin (CsA) and steroids in de novo renal transplant recipients is similar to that of mycophenolate mofetil, with one study showing a significantly lower risk of antibody-treated acute rejection with everolimus. When combined with reduced-dose CsA, everolimus is associated with improved renal function compared with full-dose CsA, with no decrease in efficacy. Thus, everolimus may play an important role in calcineurin inhibitor (CNI)-sparing regimens for renal transplant recipients. Studies with sirolimus have shown that CNI withdrawal is associated with a significant improvement in renal function, although there may be an increase in the risk of acute rejection. however, patient and graft survival are not adversely affected by CNI withdrawal. Notably, proteinuria <800 mg/day before conversion is a strong predictor of successful response to sirolimus treatment, and hypertensive therapy and serum lactate dehydrogenase levels may also predict response. Adverse events commonly associated with the PSIs include dyslipidaemia, proteinuria and anaemia, although these can usually be managed without difficulty. Data are also available to suggest that the PSIs are associated with a lower risk of malignancy than other immunosuppressive agents. In conclusion, everolimus may permit reduced exposure to CNIs in renal transplant recipients, with the potential to improve tolerability and renal function.|*Kidney Transplantation[MESH]|Acute Disease[MESH]|Calcineurin Inhibitors[MESH]|Calcineurin/physiology[MESH]|Cell Proliferation/drug effects[MESH]|Clinical Trials as Topic[MESH]|Cyclosporine/therapeutic use[MESH]|Dose-Response Relationship, Drug[MESH]|Drug Therapy, Combination[MESH]|Everolimus[MESH]|Graft Rejection/*immunology/prevention & control[MESH]|Humans[MESH]|Immunocompromised Host[MESH]|Immunosuppressive Agents/pharmacokinetics/*therapeutic use[MESH]|Postoperative Complications/prevention & control[MESH]|Practice Guidelines as Topic[MESH]|Signal Transduction/drug effects[MESH]|Sirolimus/*analogs & derivatives/pharmacokinetics/therapeutic use[MESH] |
