Web of Science: 5 citations, Scopus: 6 citations, Google Scholar: citations,
Randomized Controlled Trial Assessing the Impact of Tacrolimus Versus Cyclosporine on the Incidence of Posttransplant Diabetes Mellitus
Torres, Armando (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Hernández, Domingo (Hospital Regional Universitario de Málaga, Universidad de Málaga, IBIMA, Málaga, Spain)
Moreso, Francesc (Universitat Autònoma de Barcelona. Departament de Medicina)
Serón, Daniel (Universitat Autònoma de Barcelona. Departament de Medicina)
Burgos, María Dolores (Hospital Regional Universitario de Málaga, Universidad de Málaga, IBIMA, Málaga, Spain)
Pallardó, Luis M. (Hospital Universitario Dr Peset, Valencia, Spain)
Kanter, Julia (Hospital Universitario Dr Peset, Valencia, Spain)
Díaz Corte, Carmen (Hospital Universitario Central de Asturias, Oviedo, Spain)
Rodríguez, Minerva (Hospital Universitario Central de Asturias, Oviedo, Spain)
Diaz, Juan Manuel (Institut d'Investigació Biomèdica Sant Pau)
Silva, Irene (Institut d'Investigació Biomèdica Sant Pau)
Valdes, Francisco (Complexo Hospitalario Universitario Juan Canalejo, A Coruña, Spain)
Fernández-Rivera, Constantino (Complexo Hospitalario Universitario Juan Canalejo, A Coruña, Spain)
Osuna, Antonio (Hospital Universitario Virgen de las Nieves, Granada, Spain)
Gracia Guindo, María C. (Hospital Universitario Virgen de las Nieves, Granada, Spain)
Gómez Alamillo, Carlos (Hospital Universitario Marqués de Valdecilla, Santander, Spain)
Ruiz, Juan C. (Hospital Universitario Marqués de Valdecilla, Santander, Spain)
Marrero Miranda, Domingo (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Pérez-Tamajón, Lourdes (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Rodríguez, Aurelio (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
González-Rinne, Ana (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Alvarez, Alejandra (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Perez-Carreño, Estefanía (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
de la Vega Prieto, María José (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Henriquez, Fernando (Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de GC, Spain)
Gallego, Roberto (Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de GC, Spain)
Salido, Eduardo (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Porrini, Esteban (Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB)-Universidad de La Laguna, Tenerife, Spain)
Universitat Autònoma de Barcelona

Date: 2018
Abstract: Despite the high incidence of posttransplant diabetes mellitus (PTDM) among high-risk recipients, no studies have investigated its prevention by immunosuppression optimization. We conducted an open-label, multicenter, randomized trial testing whether a tacrolimus-based immunosuppression and rapid steroid withdrawal (SW) within 1 week (Tac-SW) or cyclosporine A (CsA) with steroid minimization (SM) (CsA-SM), decreased the incidence of PTDM compared with tacrolimus with SM (Tac-SM). All arms received basiliximab and mycophenolate mofetil. High risk was defined by age >60 or >45 years plus metabolic criteria based on body mass index, triglycerides, and high-density lipoprotein-cholesterol levels. The primary endpoint was the incidence of PTDM after 12 months. The study comprised 128 de novo renal transplant recipients without pretransplant diabetes (Tac-SW: 44, Tac-SM: 42, CsA-SM: 42). The 1-year incidence of PTDM in each arm was 37. 8% for Tac-SW, 25. 7% for Tac-SM, and 9. 7% for CsA-SM (relative risk [RR] Tac-SW vs. CsA-SM 3. 9 [1. 2-12. 4; P = 0. 01]; RR Tac-SM vs. CsA-SM 2. 7 [0. 8-8. 9; P = 0. 1]). Antidiabetic therapy was required less commonly in the CsA-SM arm (P = 0. 06); however, acute rejection rate was higher in CsA-SM arm (Tac-SW 11. 4%, Tac-SM 4. 8%, and CsA-SM 21. 4% of patients; cumulative incidence P = 0. 04). Graft and patient survival, and graft function were similar among arms. In high-risk patients, tacrolimus-based immunosuppression with SM provides the best balance between PTDM and acute rejection incidence.
Note: Número d'acord de subvenció ISCIII/FIS EC 08/00055
Note: Número d'acord de subvenció ISCIII/RD16/0009/0031
Note: Número d'acord de subvenció ISCIII/RD16/0009/0006
Note: Número d'acord de subvenció ISCIII/RD16/0009/0030
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Language: Anglès.
Document: article ; recerca ; publishedVersion
Subject: Cyclosporin A ; Posttransplant diabetes ; Posttransplant hyperglycemia ; Renal transplantation ; Steroid withdrawal ; Tacrolimus
Published in: Kidney International Reports, Vol. 3 (july 2018) , p. 1304-1315, ISSN 2468-0249

PMID: 30450457
DOI: 10.1016/j.ekir.2018.07.009


12 p, 571.6 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (scientific output) > Health sciences and biosciences > Institut d'Investigació Biomèdica Sant Pau
Articles > Research articles
Articles > Published articles

 Record created 2019-08-12, last modified 2020-02-08



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