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Tacrolimus Looks Promising for Renal Transplant Patients

Regimen with low-dose tacrolimus preserved renal function while achieving lowest rates of rejection

WEDNESDAY, Dec. 19 (HealthDay News) -- A study comparing four immunosuppressive regimens for renal transplant recipients reports that a regimen of daclizumab, mycophenolate mofetil, corticosteroids and low-dose tacrolimus resulted in the best renal function, allograft survival and acute rejection rates at 12 months post-transplant, according to an article published in the Dec. 20 issue of the New England Journal of Medicine.

Henrik Ekberg, M.D., Ph.D., of Lund University in Malmo, Sweden, and colleagues randomized 1,645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil and corticosteroids, or induction with daclizumab, mycophenolate mofetil and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus or low-dose sirolimus. Glomerular filtration rate (GFR), rate of acute rejection and allograft survival were compared among groups at 12-months post-transplant.

Compared to the other three groups, patients in the low-dose tacrolimus group had the highest mean GFR (65.4 mL/min versus 56.7 to 59.4 mL/min), lowest rates of biopsy-proven acute rejection (12.3 percent versus 24 to 37.2 percent) and highest allograft survival (94.2 percent versus 89.3 to 93.1 percent) at 12 months.

The author of an associated editorial, Alan Leichtman, M.D., of the University of Michigan Medical School in Ann Arbor, comments that longer-term data is needed to confirm these positive results of low-dose tacrolimus. "The question of whether such an approach would improve long-term function of renal allografts and the overall health and quality of life of kidney-transplant recipients remains unanswered," he writes.

The authors report receiving consulting fees and grant support from various pharmaceutical companies.

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