Chueh Shih-Chieh J, Kahan Barry D
Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Transpl Int. 2005 Mar;18(3):261-77. doi: 10.1111/j.1432-2277.2004.00039.x.
In addition to an analysis of the final results of phase I/II and phase III clinical trials of sirolimus (SRL), this review focuses on the recent results of several studies in renal transplantation, which include diverse combinations of SRL with other immunosuppressive agents. While SRL was initially introduced as an adjunctive agent to calcineurin inhibitors, it is now serving as the base for therapies that spare or avoid these nephrotoxic drugs. However, to optimize the use of SRL as base therapy, further work is necessary to determine target concentrations, requirement for concomitant steroids and/or nucleoside synthesis blockers, and countermeasure therapy to overcome the drug's adverse effects.
除了对西罗莫司（SRL）的I/II期和III期临床试验的最终结果进行分析外，本综述还重点关注了肾移植领域多项研究的近期结果，这些研究包括SRL与其他免疫抑制剂的不同组合。虽然SRL最初是作为钙调神经磷酸酶抑制剂的辅助药物引入的，但现在它正作为避免使用这些肾毒性药物的治疗基础。然而，为了优化SRL作为基础治疗的应用，有必要进一步开展工作，以确定目标浓度、联合使用类固醇和/或核苷合成阻滞剂的必要性，以及克服该药物不良反应的对策治疗。
