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Everolimus plus mycophenolate mofetil as initial immunosuppression in liver transplantation.

Identifieur interne : 001066 ( PubMed/Curation ); précédent : 001065; suivant : 001067

Everolimus plus mycophenolate mofetil as initial immunosuppression in liver transplantation.

Auteurs : M. Jiménez-Pérez [Espagne] ; R. González Grande [Espagne] ; F J Rando Mu Oz [Espagne] ; J. De La Cruz Lombardo [Espagne] ; M A Mu Oz Suárez [Espagne] ; J L Fernández Aguilar [Espagne] ; J A Pérez Daga [Espagne] ; J. Santoyo-Santoyo [Espagne] ; R. Manteca González [Espagne] ; J M Rodrigo L Pez [Espagne]

Source :

Transplantation proceedings [ 1873-2623 ]

RBID : pubmed:25645779

Descripteurs français

KwdFr :
- Acide mycophénolique (analogues et dérivés), Acide mycophénolique (usage thérapeutique), Adulte, Adulte d'âge moyen, Association de médicaments, Carcinome hépatocellulaire (), Femelle, Humains, Immunosuppresseurs (usage thérapeutique), Mâle, Rejet du greffon (), Résultat thérapeutique, Sirolimus (analogues et dérivés), Sirolimus (usage thérapeutique), Sujet âgé, Tacrolimus (usage thérapeutique), Transplantation hépatique, Tumeurs du foie (), Études de suivi, Évérolimus.
MESH :
- analogues et dérivés : Acide mycophénolique, Sirolimus.
- usage thérapeutique : Acide mycophénolique, Immunosuppresseurs, Sirolimus, Tacrolimus.
- Adulte, Adulte d'âge moyen, Association de médicaments, Carcinome hépatocellulaire, Femelle, Humains, Mâle, Rejet du greffon, Résultat thérapeutique, Sujet âgé, Transplantation hépatique, Tumeurs du foie, Études de suivi, Évérolimus.

English descriptors

KwdEn :
- Adult, Aged, Carcinoma, Hepatocellular (surgery), Drug Therapy, Combination, Everolimus, Female, Follow-Up Studies, Graft Rejection (prevention & control), Humans, Immunosuppressive Agents (therapeutic use), Liver Neoplasms (surgery), Liver Transplantation, Male, Middle Aged, Mycophenolic Acid (analogs & derivatives), Mycophenolic Acid (therapeutic use), Sirolimus (analogs & derivatives), Sirolimus (therapeutic use), Tacrolimus (therapeutic use), Treatment Outcome.
MESH :
- chemical , analogs & derivatives : Mycophenolic Acid, Sirolimus.
- chemical , therapeutic use : Immunosuppressive Agents, Mycophenolic Acid, Sirolimus, Tacrolimus.
- chemical : Everolimus.
- prevention & control : Graft Rejection.
- surgery : Carcinoma, Hepatocellular, Liver Neoplasms.
- Adult, Aged, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Liver Transplantation, Male, Middle Aged, Treatment Outcome.

Abstract

The purpose of this study was to assess the efficacy and safety of a de novo immunosuppressive regimen with everolimus (EVL) plus mycophenolate mofetil (MMF) without calcineurin inhibitors (CNI) for liver transplantation. The secondary purpose was to compare the renal function with a control group of patients treated with tacrolimus plus MMF.

DOI: 10.1016/j.transproceed.2014.11.005
PubMed: 25645779

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Carcinoma, Hepatocellular (surgery)</term>
<term>Drug Therapy, Combination</term>
<term>Everolimus</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Graft Rejection (prevention & control)</term>
<term>Humans</term>
<term>Immunosuppressive Agents (therapeutic use)</term>
<term>Liver Neoplasms (surgery)</term>
<term>Liver Transplantation</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Mycophenolic Acid (analogs & derivatives)</term>
<term>Mycophenolic Acid (therapeutic use)</term>
<term>Sirolimus (analogs & derivatives)</term>
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<term>Tacrolimus (therapeutic use)</term>
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<term>Acide mycophénolique (usage thérapeutique)</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Association de médicaments</term>
<term>Carcinome hépatocellulaire ()</term>
<term>Femelle</term>
<term>Humains</term>
<term>Immunosuppresseurs (usage thérapeutique)</term>
<term>Mâle</term>
<term>Rejet du greffon ()</term>
<term>Résultat thérapeutique</term>
<term>Sirolimus (analogues et dérivés)</term>
<term>Sirolimus (usage thérapeutique)</term>
<term>Sujet âgé</term>
<term>Tacrolimus (usage thérapeutique)</term>
<term>Transplantation hépatique</term>
<term>Tumeurs du foie ()</term>
<term>Études de suivi</term>
<term>Évérolimus</term>
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<keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Mycophenolic Acid</term>
<term>Sirolimus</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunosuppressive Agents</term>
<term>Mycophenolic Acid</term>
<term>Sirolimus</term>
<term>Tacrolimus</term>
</keywords>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Everolimus</term>
</keywords>
<keywords scheme="MESH" qualifier="analogues et dérivés" xml:lang="fr"><term>Acide mycophénolique</term>
<term>Sirolimus</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Graft Rejection</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Hepatocellular</term>
<term>Liver Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Acide mycophénolique</term>
<term>Immunosuppresseurs</term>
<term>Sirolimus</term>
<term>Tacrolimus</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Drug Therapy, Combination</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Liver Transplantation</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Association de médicaments</term>
<term>Carcinome hépatocellulaire</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Rejet du greffon</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Transplantation hépatique</term>
<term>Tumeurs du foie</term>
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<front><div type="abstract" xml:lang="en">The purpose of this study was to assess the efficacy and safety of a de novo immunosuppressive regimen with everolimus (EVL) plus mycophenolate mofetil (MMF) without calcineurin inhibitors (CNI) for liver transplantation. The secondary purpose was to compare the renal function with a control group of patients treated with tacrolimus plus MMF.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25645779</PMID>
<DateCreated><Year>2015</Year>
<Month>02</Month>
<Day>03</Day>
</DateCreated>
<DateCompleted><Year>2015</Year>
<Month>10</Month>
<Day>29</Day>
</DateCompleted>
<DateRevised><Year>2016</Year>
<Month>11</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1873-2623</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>47</Volume>
<Issue>1</Issue>
<PubDate><MedlineDate>2015 Jan-Feb</MedlineDate>
</PubDate>
</JournalIssue>
<Title>Transplantation proceedings</Title>
<ISOAbbreviation>Transplant. Proc.</ISOAbbreviation>
</Journal>
<ArticleTitle>Everolimus plus mycophenolate mofetil as initial immunosuppression in liver transplantation.</ArticleTitle>
<Pagination><MedlinePgn>90-2</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.transproceed.2014.11.005</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0041-1345(14)01257-3</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The purpose of this study was to assess the efficacy and safety of a de novo immunosuppressive regimen with everolimus (EVL) plus mycophenolate mofetil (MMF) without calcineurin inhibitors (CNI) for liver transplantation. The secondary purpose was to compare the renal function with a control group of patients treated with tacrolimus plus MMF.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Sixteen male and 4 female liver transplant patients received immunosuppression with EVL plus MMF without CNI, with induction with steroids and 16 with basiliximab also. In 10 cases it was indicated as induction immunosuppression without CNI as prevention against nephrotoxicity and neurotoxicity or recurrence of hepatocarcinoma in predisposed patients and in another 10 after withdrawing CNI during the immediate post-transplant period, before hospital discharge, as the result of toxicity, mainly nephrotoxicity and neurotoxicity or the presence of hepatocarcinoma with a high risk of recurrence. A control group comprising 31 patients taking tacrolimus plus MMF was included to compare the renal function.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">The mean follow-up time was 24 months. One patient had a recurrence of hepatocarcinoma at 8 months after transplant. The cases of nephrotoxicity and neurotoxicity resolved favorably. There were 7 rejections (35%); 2 evolved to chronic rejection with both needing retransplantation, 2 resolved with dose adjustment, and 3 required conversion to CNI. The side effects were hyperlipidemia (25%), wound dehiscence (10%), lymphedema (10%), cytomegalovirus infection (25%), myelotoxicity (25%) and proteinuria >1 g in 1 case (5%). No differences were found in renal function between the two groups.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This regimen was proven to be efficient to prevent and treat nephrotoxicity and neurotoxicity with an acceptable tolerability profile. However, the high associated rejection rate indicates that great caution is required in its use during the immediate post-transplant period. It is advisable to associate the regimen with low doses of CNI and to have agile methods available to monitor EVL to enable rapid dose adjustment.</AbstractText>
<CopyrightInformation>Copyright © 2015 Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jiménez-Pérez</LastName>
<ForeName>M</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Unidad de Hepatología-Trasplante Hepático, UGC de Aparato Digestivo, Hospital Regional Universitario de Málaga, Spain. Electronic address: mjimenezp@commalaga.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>González Grande</LastName>
<ForeName>R</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Unidad de Hepatología-Trasplante Hepático, UGC de Aparato Digestivo, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rando Muñoz</LastName>
<ForeName>F J</ForeName>
<Initials>FJ</Initials>
<AffiliationInfo><Affiliation>Unidad de Hepatología-Trasplante Hepático, UGC de Aparato Digestivo, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>de la Cruz Lombardo</LastName>
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<Author ValidYN="Y"><LastName>Muñoz Suárez</LastName>
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<AffiliationInfo><Affiliation>Unidad de Cirugía HB y Trasplante Hepático, UGC de Cirugía Digestiva, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
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<Author ValidYN="Y"><LastName>Fernández Aguilar</LastName>
<ForeName>J L</ForeName>
<Initials>JL</Initials>
<AffiliationInfo><Affiliation>Unidad de Cirugía HB y Trasplante Hepático, UGC de Cirugía Digestiva, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Pérez Daga</LastName>
<ForeName>J A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo><Affiliation>Unidad de Cirugía HB y Trasplante Hepático, UGC de Cirugía Digestiva, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Santoyo-Santoyo</LastName>
<ForeName>J</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Unidad de Cirugía HB y Trasplante Hepático, UGC de Cirugía Digestiva, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Manteca González</LastName>
<ForeName>R</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Unidad de Hepatología-Trasplante Hepático, UGC de Aparato Digestivo, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Rodrigo López</LastName>
<ForeName>J M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Unidad de Hepatología-Trasplante Hepático, UGC de Aparato Digestivo, Hospital Regional Universitario de Málaga, Spain.</Affiliation>
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<Language>eng</Language>
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<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Transplant Proc</MedlineTA>
<NlmUniqueID>0243532</NlmUniqueID>
<ISSNLinking>0041-1345</ISSNLinking>
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<NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance>
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<Chemical><RegistryNumber>9HW64Q8G6G</RegistryNumber>
<NameOfSubstance UI="D000068338">Everolimus</NameOfSubstance>
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<Chemical><RegistryNumber>HU9DX48N0T</RegistryNumber>
<NameOfSubstance UI="D009173">Mycophenolic Acid</NameOfSubstance>
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<MeshHeading><DescriptorName UI="D006528" MajorTopicYN="N">Carcinoma, Hepatocellular</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D006084" MajorTopicYN="N">Graft Rejection</DescriptorName>
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<MeshHeading><DescriptorName UI="D008113" MajorTopicYN="N">Liver Neoplasms</DescriptorName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
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<MeshHeading><DescriptorName UI="D016031" MajorTopicYN="Y">Liver Transplantation</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009173" MajorTopicYN="N">Mycophenolic Acid</DescriptorName>
<QualifierName UI="Q000031" MajorTopicYN="Y">analogs & derivatives</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020123" MajorTopicYN="N">Sirolimus</DescriptorName>
<QualifierName UI="Q000031" MajorTopicYN="Y">analogs & derivatives</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016559" MajorTopicYN="N">Tacrolimus</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
</MeshHeadingList>
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<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2015</Year>
<Month>2</Month>
<Day>4</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed"><Year>2015</Year>
<Month>2</Month>
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<PubMedPubDate PubStatus="medline"><Year>2015</Year>
<Month>10</Month>
<Day>30</Day>
<Hour>6</Hour>
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<ArticleIdList><ArticleId IdType="pubmed">25645779</ArticleId>
<ArticleId IdType="pii">S0041-1345(14)01257-3</ArticleId>
<ArticleId IdType="doi">10.1016/j.transproceed.2014.11.005</ArticleId>
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Everolimus plus mycophenolate mofetil as initial immunosuppression in liver transplantation.

Everolimus plus mycophenolate mofetil as initial immunosuppression in liver transplantation.

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