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December 30, 2024Clinical TransplantationOpen Access

A Five‐Year Prospective, Randomized, Open‐Label Study of Standard‐Dose Versus Low‐Dose Prolonged‐Release Tacrolimus With or Without Angiotensin‐Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Post Kidney Transplantation

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Authors

PCPatricia Campbell MCMarcelo Cantarovich AGAzim S. Gangji

Discussion

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Overview

Randomized trial reveals low-dose tacrolimus combined with renin-angiotensin system blockade maintains graft survival in kidney transplant recipients, indicating lower immunosuppression is feasible.

Key Points

To evaluate five-year clinical outcomes of standard-dose versus low-dose prolonged-release tacrolimus combined with renin-angiotensin system blockers or other antihypertensives in adult de novo kidney transplant recipients.
Multicenter, prospective, randomized, open-label Phase 3b trial conducted across 13 sites in Canada with 5-year follow-up (N=281; NCT00933231).
Adult de novo kidney transplant recipients with ≥1 human leukocyte antigen mismatch were randomized 2 × 2 to standard-dose versus low-dose prolonged-release tacrolimus, combined with either ACEi/ARB or other antihypertensive therapy.
Overall 5-year patient survival was 95.7%, while 5-year graft survival was 89.7% in the low-dose tacrolimus plus other antihypertensive therapy group versus 94.4%–97.1% across the other groups.
Rates of biopsy-proven acute rejection and class II de novo donor-specific antibodies were numerically higher in the low-dose tacrolimus without renin-angiotensin blockade group, but differences were not statistically significant.
Graft function, blood pressure, and proteinuria remained similar across arms, with a ≥2-fold increase in ACEi/ARB use observed after year 2 in patients initially assigned to other antihypertensives.

Cite This Study

Campbell et al. (2024) studied this question.

synapsesocial.com/papers/6a79d7fe02ab7a73dd0295d2 https://doi.org/10.1111/ctr.70067

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December 30, 2024Clinical TransplantationOpen Access

A Five‐Year Prospective, Randomized, Open‐Label Study of Standard‐Dose Versus Low‐Dose Prolonged‐Release Tacrolimus With or Without Angiotensin‐Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Post Kidney Transplantation

View Full Paper

Ask AI

Bookmark

Authors

PCPatricia Campbell MCMarcelo Cantarovich AGAzim S. Gangji

Discussion

Member takes

Overview

Randomized trial reveals low-dose tacrolimus combined with renin-angiotensin system blockade maintains graft survival in kidney transplant recipients, indicating lower immunosuppression is feasible.

Key Points

To evaluate five-year clinical outcomes of standard-dose versus low-dose prolonged-release tacrolimus combined with renin-angiotensin system blockers or other antihypertensives in adult de novo kidney transplant recipients.
Multicenter, prospective, randomized, open-label Phase 3b trial conducted across 13 sites in Canada with 5-year follow-up (N=281; NCT00933231).
Adult de novo kidney transplant recipients with ≥1 human leukocyte antigen mismatch were randomized 2 × 2 to standard-dose versus low-dose prolonged-release tacrolimus, combined with either ACEi/ARB or other antihypertensive therapy.
Overall 5-year patient survival was 95.7%, while 5-year graft survival was 89.7% in the low-dose tacrolimus plus other antihypertensive therapy group versus 94.4%–97.1% across the other groups.
Rates of biopsy-proven acute rejection and class II de novo donor-specific antibodies were numerically higher in the low-dose tacrolimus without renin-angiotensin blockade group, but differences were not statistically significant.
Graft function, blood pressure, and proteinuria remained similar across arms, with a ≥2-fold increase in ACEi/ARB use observed after year 2 in patients initially assigned to other antihypertensives.

Cite This Study

Campbell et al. (2024) studied this question.

synapsesocial.com/papers/6a79d7fe02ab7a73dd0295d2 https://doi.org/10.1111/ctr.70067

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