Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Adverse effects (AEs) of tacrolimus significantly reduce recipients’ quality of life (QOL). Given its ability for tremor improvement, this study investigates whether conversion from tacrolimus IR or XL to tacrolimus extended release (LCPT) can improve other neurological AEs such as cognitive function, insomnia, vertigo, photophobia, mood disturbances, or headache. In particular, older recipients are sensitive to neurologic toxicities and may benefit from this conversion.
*Methods: Renal transplant recipients maintained on tacrolimus IR or XL were prospectively identified for study enrollment and conversion to LCPT. The primary outcome was mean change in QOL scores from baseline to day 14 and day 28 after conversion from tacrolimus to LCPT as assessed by multiple validated questionnaires, including the Short Form Health Survey (SF-36). Secondary outcomes included: mean change in neurological scores, proportion of patients preferring LCPT to tacrolimus, and adherence with both formulations.
*Results: Results are preliminary as full statistical analyses are not complete. 40 patients were enrolled; however, 9 subjects have not completed all visits. Demographics include mean age 66.68 +/- 5.44 years, 57.5% African American, and 57.5% male. Numerical differences are noted for several of the questionnaire components. Specifically, the Neuro-QOL fatigue, sleep disturbance, and cognitive function short form demonstrated numerical improvements from baseline to day 28. Additionally, the scores on the Pittsburgh Insomnia Rating Scale assessment showed improvement from baseline to day 28. Lastly, respondents reported an improvement in adherence from 90% to 96% over the study period.
*Conclusions: LCPT exhibits a significantly different pharmacokinetic profile compared to tacrolimus IR and XL. These pharmacokinetics differences could translate into improved AEs which has been demonstrated with tacrolimus-induced tremors. The preliminary results of this conversion trial demonstrate improvements in cognition and sleep disturbances.
To cite this abstract in AMA style:Reticker A, Valdepenas B, Bruno K, Cikopana D, Walton S, Benedetti E, Tzvetanov I, West-Thielke P. An Evaluation of Converting Elderly Kidney Transplant Recipients from Tacrolimus to LCPT to Limit Neurological Adverse Events and Improve Quality of Life [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/an-evaluation-of-converting-elderly-kidney-transplant-recipients-from-tacrolimus-to-lcpt-to-limit-neurological-adverse-events-and-improve-quality-of-life/. Accessed March 4, 2021.
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