Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
The objective of this systematic review is to compare the incidence of CMV and BK virus infections in kidney transplant recipients receiving an mTORi-based as compared to a CNI-based regimen.
Methods:We underwent a comprehensive search of literature for RCTs addressing our objective.
Results:We included 33 trials,with 7277 participants,classified in 3 comparisons.Meta-analysis showed a significant reduction of CMV in mTORi groups.There was a trend towards decreased BK with mTORi.Meta-analysis for acute rejection showed an increased risk with mTORi in comparison 1 and a similar rate for comparisons 2 and 3.Estimated GFR favored the mTORi group in comparisons 1 and 2, and the CNI-based regimen in comparison 3.
|Comparison||Outcome||Conclusion||Nb of RCTs|
|1||acute rejection||increased risk in mTORi(RR 1.35, 95%CI 1.07-1.7)||19 RCTs, N=3921|
|eGFR||higher in mTORi(MD 4.07, 95% CI 1.34-6.8)||18 RCTs, N=3768|
|2||acute rejection||no difference(RR 0.88, 95% CI 0.7-1.09)||5 RCTS, N=1553|
|eGFR||trend towards higher eGFR in mTORi(MD 3.36, 95% CI -4.31,11.02)||5 RCTs, N=1543|
|3||acute rejection||trend towards decreased risk in mTORi(RR 0.82, 95% CI 0.64-1.04)||5 RCTs, N=1128|
|eGFR||lower in mTORi(MD -5.68, 95% CI -8.64, -2.72)||3 RCTs, N=539|
Conclusions: We demonstrated around 50% reduction of CMV infection in mTORi-based regimen. No definite conclusion was possible for BK.Our review suggested that a combination of an mTORi and a reduced dose CNI may offer similar rates of acute rejection, and improved GFR,when compared to a standard CNI-based regimen.
CITATION INFORMATION: Tanios B, Mallat S, Itani H, Lotfi T, Gabardi S, Akl E, Azzi J. CMV and BK Virus Infections in Kidney Transplant Recipients Receiving an mTORi-Based Regimen versus a CNI-Based Regimen: A Systematic Review and Meta-Analysis. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Tanios B, Mallat S, Itani H, Lotfi T, Gabardi S, Akl E, Azzi J. CMV and BK Virus Infections in Kidney Transplant Recipients Receiving an mTORi-Based Regimen versus a CNI-Based Regimen: A Systematic Review and Meta-Analysis. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/cmv-and-bk-virus-infections-in-kidney-transplant-recipients-receiving-an-mtori-based-regimen-versus-a-cni-based-regimen-a-systematic-review-and-meta-analysis/. Accessed October 30, 2020.
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