High-Dose Multivitamin Does Not Reduce CVD Outcomes in Transplant Patients

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Treatment of stable renal transplant recipients with a regimen of high-dose folic acid and vitamins B6 and B12 lowers total homocysteine levels better than a low-dose multivitamin containing no folic acid.
  • However, it does not reduce cardiovascular disease (CVD) outcomes or total mortality in this patient population.
  • The trial was closed early “for futility” last June after a median follow-up of 3.5 years.

Treatment of stable renal transplant recipients with a regimen of high-dose folic acid and vitamins B6 and B12 lowers total homocysteine levels better than a low-dose multivitamin containing no folic acid. However, it does not reduce cardiovascular disease (CVD) outcomes or total mortality in this patient population, according to a study presented at ASN's Renal Week 2009.

The findings, presented by Andrew G. Bostom, MD, of Rhode Island Hospital in Providence, emerged from the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) study, which was conducted at 27 sites in the United States, two in Canada, and one in Brazil. The study included 4,110 stable renal transplant recipients. The study population had a mean age of 52 years and 63% were male.

The trial was closed early “for futility” last June after a median follow-up of 3.5 years. In a sample of 143 subjects, the mean decline in total homocysteine from baseline to four years was 4.6 μmol/L in the high-dose group versus 0.2 μmol/L in the low-dose group.

The researchers observed no significant differences in CVD end points (CV death, myocardial infarction, resuscitated sudden death, stroke or specific invasive procedures for CVD, peripheral vascular disease, and renovascular disease), dialysis-dependent end-stage renal disease, or all-cause mortality.

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