Reduced-Dose Tacrolimus, Everolimus Cut CMV Infection

This article originally appeared here.
Findings in de novo kidney recipients receiving no pharmacologic CMV prophylaxis.
Findings in de novo kidney recipients receiving no pharmacologic CMV prophylaxis.

(HealthDay News) -- The incidence of cytomegalovirus (CMV) infection/disease is reduced in de novo kidney transplant recipients receiving reduced dose tacrolimus and everolimus, according to a study published in the American Journal of Transplantation.

Helio Tedesco-Silva, M.D., from the Hospital do Rim in São Paulo, Brazil, and colleagues compared CMV infection/disease incidence in de novo kidney transplant recipients receiving everolimus or mycophenolate and no CMV prophylaxis. A total of 288 patients were randomly allocated to either receive antithymocyte globulin, tacrolimus, everolimus, and prednisone (r-ATG/ EVR; 85 patients); basiliximab, tacrolimus, everolimus, and prednisone (BAS/EVR; 102 patients); or basiliximab, tacrolimus, mycophenolate, and prednisone (BAS/MPS; 101 patients).

The researchers found that, compared with BAS/MPS treatment, patients receiving r-ATG/EVR and BAS/EVR had proportional reductions of 90 and 75%, respectively, in the incidence of CMV infection/disease (hazard ratios, 0.10 and 0.25; both P < 0.001). The incidence of acute rejection, wound-healing complications, delayed graft function, and proteinuria did not differ between the groups. The mean estimated glomerular filtration rate was significantly lower with BAS/EVR.

"In de novo kidney transplant recipients receiving no pharmacological CMV prophylaxis, reduced-dose tacrolimus and everolimus was associated with a significant reduction in the incidence of CMV infection/disease compared to standard tacrolimus dose and mycophenolate," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which funded the trial.

Source

  1. Tedesco-Silva, H; Felipe, C; Ferreira, A; et al.; American Journal of Transplantation; doi: 10.1111/ajt.13327.t
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