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Once daily tacrolimus formulation: monitoring of plasma levels, graft function, and cardiovascular risk factors.

Abstract：

BACKGROUND:Advagraf, an extended release formulation of tacrolimus, is administered once daily during the morning fast. Tacrolimus can be safely converted from the twice daily formulation (Prograf) to the same dose (1 mg:1 mg) of once daily dosing tacrolimus (m-Tac). The adverse effects of tacrolimus play important roles in posttransplant cardiovascular risk factors (CVR): hyperglycemia, posttransplant diabetes mellitus, dyslipidemia and hypertension. It has been suggested that avoiding high tacrolimus peak levels minimizes its diabetogenic effects leading to better glycemic control. The aim of our study was to observe the effects of conversion to m-Tac therapy on graft function and CVR among stable transplant kidney recipients. METHODS:We selected 2 groups of 20 patients with stable kidney transplantation, who had been treated with Prograf for >6 months with a triple regimen. Group 1 were converted to once daily tacrolimus at the same dose (1 mg:1 mg); whereas in group 2, the therapy was maintained as a twice daily regimen. Blood pressure, creatinine and glomerular filtration rate levels evaluated by the Modification of Diet in Renal Disease formula, as well as urea, total, high- and low-density lipoprotein remained stable between the 2 groups as well as inside group 1 before and after conversion. RESULTS:After conversion, glycemia and triglyceride values showed significant reductions in group 1 and between the 2 groups. These results were significant, as they may be associated with better long-term graft and patient survivals.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Meçule A,Poli L,Nofroni I,Bachetoni A,Tinti F,Umbro I,Barile M,Berloco PB,Mitterhofer AP

doi

10.1016/j.transproceed.2010.03.123

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

1317-9

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(10)00462-8

journal_volume

42

pub_type

杂志文章

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