从基于钙调神经磷酸酶抑制剂的治疗方案转换为西罗莫司治疗方案。

Protocol conversion from a calcineurin inhibitor based therapy to sirolimus.

作者信息

Oberbauer Rainer

机构信息

Department of Nephrology, KH Elisabethinen, Linz and Medical University of Vienna and Austrian Dialysis and Transplant Registry, Vienna, Austria.

出版信息

Transplantation. 2009 Apr 27;87(8 Suppl):S7-10. doi: 10.1097/TP.0b013e3181a0582a.

DOI:10.1097/TP.0b013e3181a0582a

PMID:19384186

Abstract

Small late-conversion studies found an impressive glomerular filtration rate (GFR) increase 1 year after conversion from calcineurin inhibitor (CNI) to sirolimus (SRL). This effect could not be detected in the considerably larger CONVERT study, which found a lower rate of malignancies in the SRL group. In the spare the nephron trial patients converted to SRL exhibited a mean measured GFR of 68 mL/min at 1 year compared with 60 mL/min from CNI patients (P<0.05). Accordingly, the CONCEPT study which randomized patients to SRL conversion 3 months after transplantation reported a significant higher GFR in the SRL patients at 1 year. These trials showed that conversion of stable renal transplant recipients from CNI to SRL is safe.

摘要

小型的后期转换研究发现，从钙调神经磷酸酶抑制剂（CNI）转换为西罗莫司（SRL）1年后，肾小球滤过率（GFR）有显著提高。在规模大得多的CONVERT研究中未检测到这种效应，该研究发现SRL组的恶性肿瘤发生率较低。在“ sparing the nephron”试验中，转换为SRL的患者在1年时测得的平均GFR为68 mL/分钟，而CNI患者为60 mL/分钟（P<0.05）。因此，CONCEPT研究将移植后3个月的患者随机分为SRL转换组，该研究报告SRL患者在1年时的GFR显著更高。这些试验表明，稳定的肾移植受者从CNI转换为SRL是安全的。