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[Switching to Neoral in patients with a stable kidney transplant. Retrospective study]
Background:
The aim of this retrospective study of patients with stable kidney transplantation was to evaluate "in the field" whether conversion from Sandimmune to Neoral led to a reduced variability of cyclosporinemia.
Methods:
153 patients were included in the study, from 16 centres in Piedmont, and were observed for a period of 13 months each. Data from the statutory controls specified in Piedmont for the follow-up of kidney transplantation patients were used in the evaluation.
Results:
The mean coefficient of variation for cyclosporinemia (CV%) after conversion was slightly lower than pre-conversion CV% (22% vs 24%; p = 0.054). If the patients were divided into subgroups however, it was observed that only subjects who had presented a high CV% in Sandimmune (30%), equivalent to 23% of the population, showed greater stability in Neoral, whereas those who already presented satisfactory stability (CV% 20%), 45% of the population, underwent a deterioration of CV% in 42% of cases. The remaining 32% of patients revealed an intermediate level.
Conclusions:
In conclusion, this study showed that conversion to neoral is certainly indicated in those patients with a high variability of cyclosporinemia levels in sandimmun. It is not regarded as beneficial in patients with low levels of variability, also owing to the added cost. In patients with intermediate levels, ongoing studies on survival following transplantation using these two formulations will indicate the advantages or otherwise of conversion.