Pilot Study Comparing the Efficacy, Safety, Convertibility, and Tacrolimus Trough Levels of Twice-Daily Tacrolimus (Prograf) to Once-Daily Tacrolimus (Advagraf) Among Standard-Risk Kidney Transplant Patients at the National Kidney and Transplant Institute

2019 ◽  
Vol 51 (8) ◽  
pp. 2615-2619
Author(s):  
Romina A. Danguilan ◽  
Arlene Lamban ◽  
Glenda Eleanor P. Pamugas
Keyword(s):  
Pilot Study ◽  
Kidney Transplant ◽  
Once Daily ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Standard Risk ◽  
Trough Levels

scholarly journals Effects of Late Conversion from Twice-Daily to Once-Daily Slow Release Tacrolimus on the Insulin Resistance Indexes in Kidney Transplant Patients

2021 ◽  
Vol 2 (1) ◽  
pp. 49-56
Author(s):  
Valeria Cademartori ◽  
Fabio Massarino ◽  
Emanuele L. Parodi ◽  
Ernesto Paoletti ◽  
Rodolfo Russo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Kidney Transplant ◽  
Slow Release ◽  
Density Lipoprotein ◽  
Blood Levels ◽  
Transplant Recipients ◽  
Once Daily ◽  
C Peptide ◽  
Transplant Patients ◽  
Kidney Transplant Patients

The use of tacrolimus (Tac) may be involved in the development of new-onset diabetes after transplantation (NODAT) in a dose-related manner. This study aimed to evaluate the effects of a standard twice-daily formulation of Tac (TacBID) vs. the once-daily slow-release formulation (TacOD) on the basal insulin resistance indexes (Homa and McAuley), and related metabolic parameters, in a cohort of kidney transplant patients. We retrospectively evaluated 20 stable renal transplant recipients who were switched from TacBID to TacOD. Blood levels of Tac were analyzed at one-month intervals from 6 months before to 8 months after conversion. Moreover, Homa and McAuley indexes, C-peptide, insulin, HbA1c, uric acid, triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)-cholesterol serum levels and their associations with Tac levels were evaluated. We observed a significant decrease in Tac exposure (8.5 ± 2 ng/mL, CV 0.23 vs. 6.1 ± 1.9 ng/mL, CV 0.31, TacBID vs. TacOD periods, p < 0.001) and no significant changes in Homa (1.42 ± 0.4 vs. 1.8 ± 0.7, p > 0.05) and McAuley indexes (7.12 ± 1 vs. 7.58 ± 1.4, p > 0.05). Similarly, blood levels of glucose, insulin, HbA1c, lipids, and uric acid were unchanged between the two periods, while C-peptide resulted significantly lower after conversion to TacOD. These data suggest that in kidney transplant recipients, reduced Tac exposure has no significant effects on basal insulin sensitivity indexes and metabolic parameters.

scholarly journals Progression of Endothelial Dysfunction, Atherosclerosis, and Arterial Stiffness in Stable Kidney Transplant Patients: A Pilot Study

2019 ◽  
Author(s):  
Joey Junarta ◽  
Nina Hojs ◽  
Robin Ramphul ◽  
Racquel Lowe-Jones ◽  
Juan C Kaski ◽  
...  
Keyword(s):  
Pilot Study ◽  
Kidney Transplant ◽  
Cardiovascular Event ◽  
Intima Media Thickness ◽  
Post Transplantation ◽  
Vascular Abnormalities ◽  
Transplant Patients ◽  
Diabetes Status ◽  
Kidney Transplant Patients ◽  
Event Rates

Abstract Background Kidney transplant patients suffer from vascular abnormalities and high cardiovascular event rates, despite initial improvements post-transplantation. The nature of the progression of vascular abnormalities in the longer term is unknown. This pilot study investigated changes in vascular abnormalities over time in stable kidney transplant patients long after transplantation. Methods Brachial artery flow-mediated dilation (FMD), nitroglycerin-mediated dilation, carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial pressure index, and common carotid artery intima-media thickness (CCA-IMT) were assessed in 18 kidney transplant patients and 17 controls at baseline and 3-6 months after. Results There was no difference in age (51±13 vs. 46±11; P=0.19), body mass index (26±5 vs. 25±3; P=0.49), serum cholesterol (4.54±0.96 vs. 5.14±1.13; P=0.10), systolic blood pressure (BP) (132±12 vs. 126±12; P=0.13), diastolic BP (82±9 vs. 77±8; P=0.10), or diabetes status (3 vs. 0; P=0.08) between transplant patients and controls. No difference existed in vascular markers between patients and controls at baseline. In transplant patients, FMD decreased (-1.52±2.74; P=0.03), cf-PWV increased (0.62±1.06; P=0.03), and CCA-IMT increased (0.35±0.53; P=0.02). No changes were observed in controls. Conclusions Markers of vascular structure and function worsen in the post-transplant period on long-term follow-up, which may explain the continued high cardiovascular event rates in this population.

Variability of Mycophenolate Mofetil Trough Levels in Stable Kidney Transplant Patients

2007 ◽  
Vol 39 (7) ◽  
pp. 2185-2186 ◽  
Author(s):  
A. Fernández ◽  
J. Martins ◽  
J.J. Villlafruela ◽  
R. Marcén ◽  
J. Pascual ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Kidney Transplant ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Trough Levels

Improvement of Graft Function after Conversion to Once Daily Tacrolimus of Stable Kidney Transplant Patients

2010 ◽  
Vol 42 (10) ◽  
pp. 4047-4048 ◽  
Author(s):  
F. Tinti ◽  
A. Meçule ◽  
L. Poli ◽  
A. Bachetoni ◽  
I. Umbro ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Function ◽  
Once Daily ◽  
Transplant Patients ◽  
Kidney Transplant Patients

P1774CONVERSION FROM TWICE-DAILY TACROLIMUS (TAC-IR) TO ONCE-DAILY EXTENDED RELEASE TACROLIMUS (LCPT) IN EVEROLIMUS TREATED STABLE KIDNEY TRANSPLANT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Orsolya Cseprekal ◽  
Adrienn Marton ◽  
Szilárd Török ◽  
Attila Patonai ◽  
Katalin Földes ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Extended Release ◽  
Total Daily Dose ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Observational Period ◽  
Once Daily ◽  
Transplant Patients ◽  
Daily Dose ◽  
Kidney Transplant Patients

Abstract Background and Aims Stable kidney transplant patients (KTX) treated according to TRANSFORM study protocol (TAC-IR + everolimus (EVR) + corticosteroid) were converted from twice daily TAC-IR to novel (MELT-dose) once-daily tacrolimus formulation (LCPT) on a 1:0.7 total daily dose (TDD) basis. Tolerability, safety, and trough level (Co) – TDD characteristics of the conversion (CV) was analyzed in a single center retrospective observational study. Method Between Sep. 2017 and Aug. 2018 38 KTX recipients were included. Pre- and post-CV TAC TDD, Co and TAC Co/D as well as EVR TDD and Co data were evaluated 4, 2 weeks before and 4 consecutive times after CV (94 (74-112 median IQR) post-transplant days). Pre- and post-CV eGFR, routine lab parameters and occurrence of adverse events were also investigated. Results In one patient 2 weeks after CV EVR was stopped due to infection, 37 KTX (males 22 (58%), age 54 (42-63) years) finished the entire observational period. According to CV protocol the median TDD of LCPT was lower than pre-CV TAC-IR at each visit: 4.5(3.5-7) mg/day pre-CV versus 3.5 (2.5-5), 3.6 (2.5-5), 3.5 (2.5-5) and 3.5 (2-5) (p&lt;0.001) post-CV. Mean TAC Co decreased from pre-CV Co 7.8 (6.4-9.5) ng/ml to 6.7 (4.8, 8.6), 7.0 (5.2, 9.6), 6.5 (5.7, 8.4) and 7.2 (5.4, 8.7) (p&lt;0.001). LCPT Co /TDD did not change: 1.6 (1.1-2.5) pre- and 2.1 (1.1- 2.9), 2.1 (1.1- 4.1), 1.6 (1.3- 3.5), 2.0 (1.4-4.1) (p = 0.18) post-CV. EVR Co /TDD (1.6 (1.3-2.1), 1.6 (1.3; 2.3), 1.6 (1.3-2.0), 1.6 (1.2-2.2)) remained similar to pre-CV: 1.6 (1.4- 2.4) (p = 0.65). There was no change in eGFR, hemoglobin levels and no drug related adverse event was observed during the study period. Conclusion Conversion from TAC-IR to LCPT in everolimus treated stable KTX recipients resulted in a significant post-CV decrease in TAC- Co, whilst Co/TDD remained unchanged. The conversion was safe and had no effect on EVR Co and TDD. Further investigations are needed to define optimal TAC-IR to LCPT conversion dose rate.

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