Yang S-S, Choi J-Y, Cho W-T, Park J B, Kim S J
Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Transplant Proc. 2015 Apr;47(3):617-21. doi: 10.1016/j.transproceed.2014.12.042.
Compliance with immunosuppressive regimens may affect clinical outcomes in renal transplant recipients. The aim of this study was to assess the safety and efficacy of standard-dose tacrolimus modified-release (TAC-MR) once daily versus tacrolimus (TAC) twice daily in stable renal transplant recipients.
Ninety-nine stable renal transplant recipients were randomized to receive standard-dose tacrolimus twice daily or standard-dose modified-release tacrolimus once daily on a 1:1 (mg:mg) basis. The primary end point was the incidence of adverse events (AEs) in both groups. Secondary end points included biopsy-proven acute rejection, graft survival, patient survival, clinical indicators, and change in score of questionnaire.
The incidence of AEs was not different between the TAC and TAC-MR groups (56.0% vs 53.1%, P > .05). There were no significant differences in mean calculated glomerular filtration rate, blood pressure, glycosylated hemoglobulin (HbA1c), blood concentration of tacrolimus, and drug compliance. The scores of all items in the 36-item short form health survey (SF-36) were not different between groups, except for vitality. With respect to the subject questionnaire, there was no difference in question scores between the two treatment groups.
A regimen of TAC-MR once daily can be considered as an effective and safe alternative formulation of tacrolimus in stable renal transplant patients.
肾移植受者对免疫抑制方案的依从性可能会影响临床结局。本研究的目的是评估在稳定的肾移植受者中,每日一次标准剂量他克莫司缓释制剂(TAC-MR)与每日两次他克莫司(TAC)的安全性和有效性。
99名稳定的肾移植受者按1:1(毫克:毫克)的比例随机分为每日两次接受标准剂量他克莫司或每日一次接受标准剂量缓释他克莫司。主要终点是两组中不良事件(AE)的发生率。次要终点包括活检证实的急性排斥反应、移植物存活、患者存活、临床指标以及问卷评分的变化。
TAC组和TAC-MR组的AE发生率无差异(56.0%对53.1%,P>.05)。平均计算的肾小球滤过率、血压、糖化血红蛋白(HbA1c)、他克莫司血药浓度和药物依从性方面无显著差异。除活力外,两组间36项简明健康调查(SF-36)所有项目的评分无差异。关于受试者问卷,两个治疗组的问题评分无差异。
对于稳定的肾移植患者,每日一次TAC-MR方案可被视为他克莫司一种有效且安全的替代剂型。