Reduced-Dose Tacrolimus, Everolimus Cut CMV Infection
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.