What question did this study set out to answer?

To evaluate the 24-month efficacy and safety of converting maintenance kidney transplant recipients from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus.

January 20, 2009Transplantation

Conversion From Calcineurin Inhibitors to Sirolimus Maintenance Therapy in Renal Allograft Recipients: 24-Month Efficacy and Safety Results From the CONVERT Trial

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Authors

FSFrancesco Paolo SchenaUniversity of Bari Aldo Moro MPM.D. PascoeUniversity of Cape Town JAJosefina AlberúInstituto Tecnológico Autónomo de México

Discussion

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Implication

Randomized trial demonstrates improved kidney function and reduced malignancy after sirolimus conversion in kidney transplant recipients, indicating benefit in patients with preserved baseline GFR.

Key Points

To evaluate the 24-month efficacy and safety of converting maintenance kidney transplant recipients from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus.
Randomized trial of 830 renal allograft recipients (6 to 120 months posttransplant) assigned to continue calcineurin inhibitor therapy (n=275) or convert to sirolimus (n=555).
Primary endpoints were calculated Nankivell glomerular filtration rate (GFR; stratified at baseline: 20-40 vs. >40 mL/min) and cumulative rates of biopsy-confirmed acute rejection, graft loss, or death at 12 months, with follow-up through 24 months.
Enrollment in the baseline GFR 20 to 40 mL/min stratum was stopped prematurely due to an increased rate of safety endpoints in the sirolimus conversion arm.
In the baseline GFR >40 mL/min stratum, intent-to-treat analyses showed no statistically significant difference in GFR at 12 or 24 months, but on-therapy analysis demonstrated significantly higher GFR following sirolimus conversion.
Sirolimus conversion led to significantly lower malignancy rates at 12 and 24 months alongside significantly increased median urinary protein-to-creatinine ratios compared with calcineurin inhibitor continuation.
Post hoc analysis identified that patients with baseline GFR >40 mL/min and urinary protein-to-creatinine ratio ≤0.11 experienced the most favorable risk-benefit profile after conversion.

Cite This Study

Schena et al. (2009) studied this question.

synapsesocial.com/papers/6a033c8759ea043e4c9e482d https://doi.org/10.1097/tp.0b013e3181927a41

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January 20, 2009Transplantation

Conversion From Calcineurin Inhibitors to Sirolimus Maintenance Therapy in Renal Allograft Recipients: 24-Month Efficacy and Safety Results From the CONVERT Trial

View Full Paper

Ask AI

Bookmark

Authors

FSFrancesco Paolo SchenaUniversity of Bari Aldo Moro MPM.D. PascoeUniversity of Cape Town JAJosefina AlberúInstituto Tecnológico Autónomo de México

Discussion

Member takes

Implication

Randomized trial demonstrates improved kidney function and reduced malignancy after sirolimus conversion in kidney transplant recipients, indicating benefit in patients with preserved baseline GFR.

Key Points

To evaluate the 24-month efficacy and safety of converting maintenance kidney transplant recipients from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus.
Randomized trial of 830 renal allograft recipients (6 to 120 months posttransplant) assigned to continue calcineurin inhibitor therapy (n=275) or convert to sirolimus (n=555).
Primary endpoints were calculated Nankivell glomerular filtration rate (GFR; stratified at baseline: 20-40 vs. >40 mL/min) and cumulative rates of biopsy-confirmed acute rejection, graft loss, or death at 12 months, with follow-up through 24 months.
Enrollment in the baseline GFR 20 to 40 mL/min stratum was stopped prematurely due to an increased rate of safety endpoints in the sirolimus conversion arm.
In the baseline GFR >40 mL/min stratum, intent-to-treat analyses showed no statistically significant difference in GFR at 12 or 24 months, but on-therapy analysis demonstrated significantly higher GFR following sirolimus conversion.
Sirolimus conversion led to significantly lower malignancy rates at 12 and 24 months alongside significantly increased median urinary protein-to-creatinine ratios compared with calcineurin inhibitor continuation.
Post hoc analysis identified that patients with baseline GFR >40 mL/min and urinary protein-to-creatinine ratio ≤0.11 experienced the most favorable risk-benefit profile after conversion.

Cite This Study

Schena et al. (2009) studied this question.

synapsesocial.com/papers/6a033c8759ea043e4c9e482d https://doi.org/10.1097/tp.0b013e3181927a41

Also Consider

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