Advantages of Neoral conversion in renal transplant patients

Sandimmun Neoral is a microemulsion formulation of Sandimmun cyclosporin (Cya) with predictable pharmacokinetics, superior absorption and less dependent upon bile production. Recently Neoral replaced the old Cya in the clinical ground.

The aim of this study was to assess the effectiveness, safety and advantages of this conversion in 90 adult renal transplant patients with stable renal function transplanted at least 24 months earlier. There were 48 males and 42 females with a mean age of 39 years (range: 18-56). Mean interval from transplant to conversion was 3.6 years (range: 2.7-5.4). Conversion rate was 1:1. Mean Neoral dose at conversion was 3.8 mg/kg/day (range: 2.1-5.7).

One month after conversion mean Neoral dose was 3.4 mg/kg/day (range: 2.2-3.9) and at six months was 3.2 mg/kg/day (range: 2.1-4). Serum creatinine and CyA trough levels remained stable. We did not observe rejection episodes or infections. The incidence of side effects due to CyA was slightly increased and there were not differences in terms of arterial pressure values and number of antihypertensive drugs given.

The conclusion is drown that conversion to Neoral is safe and results in rapid attainment of therapeutic trough levels. Six months after conversion the mean Neoral dose was decreased of 0.6 mg/kg/die per patient.