December 14, 2009

Everolimus with Very Low-Exposure Cyclosporine A in De Novo Kidney Transplantation: A Multicenter, Randomized, Controlled Trial

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Like sirolimus, everolimus is an inhibitor of mTOR. Previous studies have shown that the combination of a calcineurin inhibitor at full-dose with an mTOR inhibitor is associated with increased nephrotoxicity. This RCT compared standard-dose everolimus and low-dose cyclosporine to high-dose everolimus and very-low dose cyclosporine (measured by C2 levels, which are more accurate). There was no difference in renal function or rejection between groups, but there were more graft losses in the low-dose cyclosporine arm. This trial does not include a comparison with a cyclosporine and mycophenolic acid-containing regimen.

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