一个随机对照试验Envarsus对立即释放的tacrolimus在脏移植接受者与延迟的移植功能
Sandesh Parajuli1, Brenda Muth1, Margaret Bloom1
1Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Transplantation proceedings
|July 2, 2023
概括
与立即释放的塔克罗利莫斯相比,延长释放的塔克罗利莫斯 (Envarsus) 在移植受体中使用,移植功能延迟 (DGF) 导致较少的氨酸抑制剂 (CNI) 剂量调整. 然而,两种配方之间的移植恢复时间和透析需求仍然相似.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植 移植 移植 移植
- 药理学 药理学是指药理学的学科.
背景情况:
- 延迟移植功能 (DGF) 的发生率在美国移植接受者 (KTRs) 中正在上升.
- 立即释放塔克罗利莫斯与延长释放塔克罗利莫斯 (Envarsus) 在KTR与DGF的比较疗效尚未得到充分证实.
研究的目的:
- 为了比较立即释放的塔克罗利莫斯和恩瓦苏斯对脏移植接受者的DGF恢复的影响.
- 评估需要调整卡尔西纽林抑制剂 (CNI) 剂量的必要性,在KTR中,DGF接受了任何一种塔克罗利斯配方的治疗.
主要方法:
- 一个单中心,开放标签,随机对照试验 (NCT03864926) 涉及100个KTR与DGF.
- 参与者被随机分配1:1继续立即释放的塔克罗利斯或切换到Envarsus.
- 结果包括DGF持续时间,透析治疗和CNI剂量调整.
主要成果:
- 招募了100个KTR;分析了97个 (49个Envarsus,48个tacrolimus).
- 在DGF持续时间 (中位数为5天与4天) 或透析治疗 (中位数为2天与2天) 中没有发现显著差异.
- 恩瓦苏斯组需要CNI剂量调整的次数显著减少 (中位数为3比4).
结论:
- 恩瓦苏斯显示CNI水平波动减少,需要较少的剂量调整在KTRs与DGF.
- 在Envarsus和即时释放塔克罗利木斯之间,移植恢复时间和透析治疗次数是可比的.
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