Document Detail


Safety and efficacy of everolimus after kidney and hematopoietic stem cell transplantation.
MedLine Citation:
PMID:  23274324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this retrospective study was to investigate the efficacy of everolimus at our institution and to report incidence and type of side effects in patients who underwent kidney transplantation or hematopoietic stem cell transplantation (HSCT).
MATERIAL/METHODS: Electronic medical records were evaluated for 122 patients (76 men and 46 women) treated with everolimus between January 2000 and January 2009. Of these patients, 81 had undergone kidney transplantation (mean age: 56±12 years) and 41 patients were treated with HSCT (mean age: 47±11 years).
RESULTS: Everolimus was discontinued in a total of 53% of patients (n=64) with no difference observed in kidney transplant recipients vs. stem cell transplanted patients (p=0.85). In one half of the patients, cessation of the drug was due to a lack of long-term efficacy (n=32). In the other half, everolimus was discontinued due to side effects (n=32). However, patients with side effects had no elevated everolimus concentrations (5.5±2.3 vs. 5.2±1.7 ng/ml; p=0.39). Pneumonitis (n=5) or proteinuria over 1.5 g per day (n=13) were only observed in kidney transplant patients, while polyomavirus-induced cystitis (n=3) and thrombotic thrombocytopenic purpura (n=7) were only observed in stem cell transplanted patients.
CONCLUSIONS: Everolimus was an effective immunosuppressive agent in half of the patients. A quarter of all patients developed side effects resulting in discontinuation of the drug. The profile of side effects in kidney recipients clearly differs from hematopoietic stem cell transplanted patients.
Authors:
Frieder Keller; Susanne Wiesner; Donald Bunjes; Bertram Hartmann; Michael Schmitt
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  17     ISSN:  2329-0358     ISO Abbreviation:  Ann. Transplant.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-05-28     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  52-8     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, Germany. frieder.keller@uni-ulm.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Follow-Up Studies
Graft Rejection / prevention & control*
Graft vs Host Disease / prevention & control*
Hematopoietic Stem Cell Transplantation*
Humans
Immunosuppressive Agents / adverse effects,  therapeutic use*
Kidney Transplantation / immunology*
Male
Middle Aged
Retrospective Studies
Sirolimus / adverse effects,  analogs & derivatives*,  therapeutic use
Treatment Outcome
Withholding Treatment / statistics & numerical data
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 159351-69-6/everolimus; 53123-88-9/Sirolimus

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