Cyclosporine mono-drug therapy

In two sequential controlled clinical trials, patients undergoing cadaveric kidney transplantation was allocated to receive Cs alone (8 to 10 mg/kg/d) or combination therapy, which consisted of either Cs, azathioprine, and prednisolone, or Cs and azathioprine. The two trials have been combined, and the 58 patients that received Cs alone have been compared with the 52 that received Cs in combination with other drugs. Although rejection episodes were more frequent with Cs monotherapy, graft survival was not compromised and 80% of first grafts were functioning at 1 year. The monotherapy group had significantly fewer serious infections, and 75% of the patients in this group are still taking no steroids. Cs monotherapy is much cheaper than double, triple, or quadruple regimens and we believe that it should be the treatment of choice for the majority of patients undergoing kidney transplantation.