Early Exposure of Everolimus with and without Calcineurin Inhibitors.
Nephrology Division, Hospital do Rim, UNIFESP, São Paulo, SP, Brazil
Meeting: 2017 American Transplant Congress
Abstract number: D113
Keywords: Calcineurin, Immunosuppression, Kidney transplantation, Pharmacokinetics
Session Information
Session Name: Poster Session D: Kidney Immunosuppression: Novel Regimens and Drug Minimization
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
This study aimed to evaluate the effect of cyclosporine (CSA) or tacrolimus (TAC) on early exposure of everolimus (EVR).
A cohort of 306 kidney transplant recipients were selected according to the initial immunosuppressant regimens: reduced dose CSA combined with EVR 0.75 mg BID (CSA/EVR0.75, N= 32) or 1.5 mg BID (CSA/EVR1.5, N= 31), reduced dose TAC combined with EVR 1.5 mg BID (TAC/EVR1.5, N= 176) and EVR 1.5 mg BID (EVR1.5, N= 67) alonewith TAC introduction at day 7. EVR blood concentrationswere compared at day 3 after transplantation.
Results: Recipient age (42±14. vs. 40±12 vs. 44±14 vs. 52±12, p= 0.000 years),proportion of diabetes mellitus (17%. vs. 3% vs. 9% vs. 25%, p= 0.000) and proportion of grafts from living donors (91% vs. 97% vs. 30% vs. 0%, p= 0.000) were different among the groups, respectively.
Dose adjusted EVR concentrations were higher when combined with CSA than with TAC or alone. No differences were observed comparing dose adjusted EVR concentrations combined with TAC or alone. The proportion of patients with EVR concentration below the target range (<3 ng/ml) was higher when combined with TAC or when administered alone.
| Table 1 | CSA + EVR
N= 32 |
CSA + EVR
N= 31 |
TAC + EVR
N= 176 |
EVR
N= 67 |
p |
| EVR dose, mg BID | 0.75 | 1.5 | 1.5 | 1.5 | 0.000 |
| EVR concentration, ng/mL | 5.0 ± 4.4 | 8.1 ± 3.3 | 3.6 ± 1.3 | 3.3 ± 1.0 | 0.000 |
| Dose adjusted EVR concentration, ng/mL/mg | 6.7 ± 5.9 | 5.4 ± 2.2 | 2.4 ± 0.9 | 2.2 ± 0.7 | 0.000 |
| Patients with EVR bellow 3ng/mL (%) | 8 (25) | 1 (3) | 67 (38) | 33 (49) | |
| Patients with EVR between 3- 8 ng/mL (%) | 21 (66) | 16 (52) | 107 (61) | 34 (51) | |
| Patients with EVR above 3ng/mL (%) | 2 (6) | 14 (45) | 2 (1) | 0 | |
Conclusion: In de novo kidney transplant recipients, the initial dose of EVR should consider the choice of calcineurin inhibitor (CSA or TAC) to achieve EVR target concentration range in a higher proportion of patients.
CITATION INFORMATION: Felipe C, Ferreira A, Abait T, Bessa A, Ruppel P, Hiramoto L, Ivani M, Tedesco H, Medina- Pestana J. Early Exposure of Everolimus with and without Calcineurin Inhibitors. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Felipe C, Ferreira A, Abait T, Bessa A, Ruppel P, Hiramoto L, Ivani M, Tedesco H, Pestana JMedina-. Early Exposure of Everolimus with and without Calcineurin Inhibitors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/early-exposure-of-everolimus-with-and-without-calcineurin-inhibitors/. Accessed May 9, 2025.« Back to 2017 American Transplant Congress