The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
SIROLIMUS ALLOWS EARLY CYCLOSPORINE WITHDRAWAL IN RENAL TRANSPLANTATION RESULTING IN IMPROVED RENAL FUNCTION AND LOWER BLOOD PRESSURE1,2,10
Abstract
INTRODUCTION: This study evaluated whether cyclosporine (CsA) could be eliminated from a sirolimus (Rapamune, rapamycin, SRL)-CsA-steroid (ST) regimen at 3 months. METHODS: This was an open-label study conducted in Europe, Australia, and Canada. Upon enrollment, 525 primary (90%) or secondary (10%) renal allograft recipients with cadaveric (89%) or living (11%) donors received 2 mg of sirolimus (troughs>5 ng/ml), CsA, and steroids. At 3 months+/-2 weeks, eligible patients were randomized (1:1) to remain on SRL-CsA-ST or to have CsA withdrawn and therapy continued with SRL (troughs 20-30 ng/ml)-ST. RESULTS: At 12 months, overall graft and patient survival were 89.1% and 94.9%, respectively. In the 430 (82%) randomized patients, there was no difference in graft survival (95.8% vs. 97.2%, SRL-CsA-ST vs. SRL-ST) or patient survival (97.2% vs. 98.1%, respectively). The incidence of biopsy-confirmed primary acute rejection was 13.1% during the prerandomization period. After randomization, the acute rejection rates were 4.2% and 9.8% for SRL-CsA-ST and SRL-ST, respectively (P=0.035). Renal function (calculated glomerular filtration rate, 57 vs. 63 ml/min, P<0.001) and blood pressure significantly improved when CsA was withdrawn. Hypertension, CsA nephrotoxicity, hyperuricemia, and Herpes zoster occurred statistically more frequently in patients remaining on CsA, whereas thrombocytopenia, abnormal liver function tests, and hypokalemia were reported more often for SRL-ST therapy. CONCLUSION: Sirolimus, CsA, and steroids for 3 months posttransplant, followed by elimination of CsA, is a safe and effective alternative to continuous therapy with sirolimus, CsA, and steroids that can result in better renal function and lower blood pressure.
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Self-citationNew insights into the pharmacodynamic and pharmacokinetic properties of statins
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Cited by
Mechanisms of Dysfunction in the Aging Vasculature and Role in Age-Related Disease
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Biological Versus Chronological Aging
Hamczyk, M. R., Nevado, R. M., Barettino, A., Fuster, V., & Andrés, V. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.11.062 · Cited by 489
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Metadata
- Authors
- Johnson, R. W. G., Kreis, H., Oberbauer, R., Brattstrom, C., Claesson, K., & Eris, J.
- Venue
- Transplantation
- Published
- 2001-09
- Volume
- 72
- Issue
- 5
- Pages
- 777-786
- ISSN
- 0041-1337 (ISSN-L)
- OpenAlex
- W2031006751
- Cited by
- 433
- References
- 34
- FWCI
- 26.68
- Type
- journal article
- Language
- en
- Open access
- closed
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