Everolimus May Be An Option for Rescue Therapy

SAN DIEGO—Everolimus may be useful as rescue therapy for chronic allograft nephropathy (CAN) and after onset of acute rejection, researchers reported at Kidney Week 2012.

A team at Sir Ganga Ram Hospital in New Delhi, India, studied 30 transplant recipients on triple-drug immunosuppression who were switched to an everolimus-based regimen because of “creeping” creatinine levels or acute rejection. Graft biopsies showed that 23 of them had CAN and seven had acute rejection. Cyclosporine A or tacrolimus doses were reduced by 50%-80% in 24 patients (group 1) and discontinued in six (group 2). Mycophenolate or azathiprine were discontinued in five patients in group 1. All patients received prednisolone. The mean trough level of everolimus was 5.2 ng/mL.

The patients were followed up for a mean of 12 months (range 1-24 months). Mean serum creatinine values decreased significantly from 2.6 mg/dL at baseline to 1.8 mg/dL at the end of the study. Patient and graft survival was 100%. 

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