Clinical Outcomes with IR-tac to LCP-tac Conversion in a Kidney Transplant Population

F. Bartlett¹, J. Newman¹, T. Sprague¹, S. Patel¹, N. Rao², E. Andrade², V. Rohan², M. Casey², D. Dubay¹, D. Taber¹

¹Pharmacy, Medical University of South Carolina, Charleston, SC, ²Medical University of South Carolina, Charleston, SC

Meeting: 2022 American Transplant Congress

Abstract number: 994

Keywords: Adverse effects, Graft function, Infection, Kidney transplantation

Topic: Clinical Science » Infection Disease » 25 - Kidney Infectious Non-Polyoma & Non-Viral Hepatitis

Session Information

Session Name: Kidney Infectious Non-Polyoma & Non-Viral Hepatitis

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: LCP-Tac is approved for conversion from IR-Tac in kidney transplant patients with a conversion rate of 70-80%. Studies have demonstrated similar efficacy and safety outcomes between the two agents, with improvement in neurotoxicity with LCP-Tac. The goal of this study was to assess real world long-term safety and effectiveness outcomes after conversion from IR-Tac to LCP-Tac in a large kidney transplant population.

*Methods: This was a retrospective longitudinal cohort study of adult kidney transplant recipients converted from IR-Tac to LCP-Tac between June 2019 and October 2020. Patients converted back to IR-Tac within 1 month were excluded. Tacrolimus pharmacokinetic data and clinical outcomes were collected 1-year pre- and post-conversion. Continuous data were analyzed using a paired T-test and categorical data using the McNemar test.

*Results: A total of 337 patients were screened with 292 patients included in the analysis. The mean recipient age was 52.9 years; 63% were black and 43% were female. Median number of days from transplant to conversion was 481 (227,775) with 35% converted within 1-year. There was no difference in acute cellular rejection rates pre- and post-conversion (ACR; P=0.34), with similar time in therapeutic range (TTR; P=0.59) as well. Coefficient of variation was higher post-conversion (29 v 34%, P<0.01). There was a higher rate of CMV infection pre-conversion (10 v 3%, P<0.01) and numerically higher rate of BK viremia (7 v 3%, P=0.05). The rate of other documented infections was similar pre- and post-conversion. Neurotoxicity burden tended to being less common post-conversion, as did hypomagnesemia and hyperkalemia (Table 1). Graft and patient survival were excellent (95% and 97%, respectively) at 3-years post-transplant.

*Conclusions: Conversion to LCP-Tac in kidney transplantation is safe, with similar rates of infection, AKI, and rejection pre- and post-conversion. Neurotoxicity burden and electrolyte abnormalities tended to be less common after conversion to LCP-Tac.

To cite this abstract in AMA style:

Bartlett F, Newman J, Sprague T, Patel S, Rao N, Andrade E, Rohan V, Casey M, Dubay D, Taber D. Clinical Outcomes with IR-tac to LCP-tac Conversion in a Kidney Transplant Population [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/clinical-outcomes-with-ir-tac-to-lcp-tac-conversion-in-a-kidney-transplant-population/. Accessed November 21, 2024.

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