Posts Tagged ‘everolimus’

June 21, 2013

Everolimus versus mycophenolate mofetil in heart transplantation: a randomized, multicenter trial.


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This multicenter trial randomized de novo heart transplant recipients to everolimus 1.5 mg or 3.0 mg with reduced-dose cyclosporine, or mycophenolate mofetil (MMF) 3 g/day with standard-dose cyclosporine (plus corticosteroids ± induction). Primary efficacy endpoint was the 12-month composite incidence of biopsy-proven acute rejection, acute rejection associated with hemodynamic compromise, graft loss/retransplant, death or loss […]

No Comments Posted in Cardiac Transplantation
June 21, 2013

Everolimus immunosuppression in de novo heart transplant recipients: What does the evidence tell us now?


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This review article analyzes the currently available data supporting the use of everolimus in de novo heart transplant patients. Rejection, renal function, malignancy, infection and wound complications including pleural and pericardial effusions are examined. The evidence suggests that the most convincing reasons for use of everolimus are to slow the progression of CAV and to […]

No Comments Posted in Cardiac Transplantation
June 21, 2013

Everolimus Versus Mycophenolate Mofetil in Heart Transplantation: A Randomized, Multicenter Trial.


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This multicenter, randomized controlled trial assessed the efficacy, safety and incidence of CAV in de novo heart transplant patients receiving everolimus at two doses (1.5 mg/day or 3.0 mg/day in divided doses) with reduced-dose cyclosporine versus MMF with full-dose cyclosporine. The high dose everolimus group was terminated due to increased mortality. The lower dose everolimus […]

No Comments Posted in Cardiac Transplantation
June 21, 2013

Differential Effect of Everolimus on Progression of Early and Late Cardiac Allograft Vasculopathy in Current Clinical Practice.


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CAV remains the leading cause of long-term death in heart transplant recipients. This retrospective analysis of prospectively collected data (IVUS) demonstrated everolimus independently reduced the odds for early CAV (0.14 [0.01_0.77]; p 0.02) but it did not appear to influence late CAV progression. High dose statin use was favorably associated with a reduction in both […]

No Comments Posted in Cardiac Transplantation
October 30, 2012

Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial


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This randomized controlled study reviews the changes in plaque morphology in maintenance heart transplant recipients on everolimus and reduced calcineurin inhibitor vs standard therapy. Conversion to everolimus and reduced calcineurin inhibitor was associated with a significant increase in calcified and necrotic intimal components and is more prominent in patients with a longer time since HTx. […]

No Comments Posted in Cardiac Transplantation
August 17, 2012

A Randomized, Controlled Study to Assess the Conversion From Calcineurin-Inhibitors to Everolimus After Liver Transplantation-PROTECT


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Post transplant inmunosuppression with calcineurin inhibitors (CNIs) is associated with renal dysfunction with an estimated rate of advanced CKD of 20% at 5 years. Everolimus is an mTOR inhibitors without the nephrotoxicity of CNIs. In this multicenter, prospective study, the authors evaluate the feasibility and effects of everolimus started at 30 days post liver transplant. […]

No Comments Posted in Liver Transplantation
April 14, 2012

Conversion from Cyclosporine to Everolimus at 4.5 Months Posttransplant: 3-Year Results from the Randomized ZEUS Study

This paper prevents further results from a randomized controlled trial of mandatory conversion from cyclosporine to everolimus. There remains a higher acute rejection rate in the everolimus-treated patients. However, renal function remained better in the everolimus arm. As in many such trials, a significant number of patients treated with everolimus had to change to other […]

No Comments Posted in Renal Transplantation
April 14, 2012

Cyclosporine lowering with everolimus versus mycophenolate mofetil in heart transplant recipients: Long-term follow-up of the SHIRAKISS randomized, prospective study.


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This publication reveals long-term follow-up of 34 patients initially randomized to a study exploring two different cyclosporine-lowering approaches in reducing the progression of renal dysfunction in heart transplant recipients.  Cyclosporine trough levels remained stable in both arms and were significantly lower in the everolimus arm at all time-points. Proteinuria increased significantly during the first 12 […]

No Comments Posted in Cardiac Transplantation
October 1, 2011

Conversion of Long-Term Kidney Transplant Recipients From Calcineurin Inhibitor Therapy to Everolimus: A Randomized, Multicenter, 24-Month Study


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The ASCERTAIN study was a randomized controlled trial comparing three strategies: replacement of calcineurin inhibitor (CnI) with everolimus; addition of everolimus and CnI reduction; or CnI minimization. There was no difference in renal function, acute rejection rates or graft loss at 2 years. Of note, the mean time post-transplant of patients in this trial was […]

No Comments Posted in Renal Transplantation
April 24, 2011

Everolimus-based, calcineurin-inhibitor-free regimen in recipients of de-novo kidney transplants: an open-label, randomised, controlled trial


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Everolimus is an mTOR inhibitor and does not cause the nephrotoxicity seen with cyclosporine or tacrolimus. Use of mTOR inhibitors as initial immunosuppression at the time of transplant is associated with a higher risk of acute rejection. In this RCT, patients 4.5 months post-transplant were randomized to continue cyclosporine or switch to everolimus. At 12 […]

No Comments Posted in Renal Transplantation