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Volume 36 Issue 1
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Article Navigation >  Journal of Pharmaceutical Practice and Service  > 2018  >  36(1): 75-79

WEI Zewu, ZHANG Wenwen, MA Duoling, BI Juan, CHEN Jiexiu, YANG Yunyun. A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(1): 75-79. doi: 10.3969/j.issn.1006-0111.2018.01.016
Citation: WEI Zewu, ZHANG Wenwen, MA Duoling, BI Juan, CHEN Jiexiu, YANG Yunyun. A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(1): 75-79. doi: 10.3969/j.issn.1006-0111.2018.01.016
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A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus

doi: 10.3969/j.issn.1006-0111.2018.01.016

  • Department of Pharmacy, Changhai Hospital Affiliated to Second Military Medical University, Shanghai 200433, China

  • Received Date: 2017-02-20
  • Rev Recd Date: 2017-06-30
  • Objective To study the efficacy and adverse reactions for renal transplant patients conversed from cyclosporine A to tacrolimus. Methods The follow-up data of renal transplant patients conversed from cyclosporine A to tacrolimus were collected. The clinical therapeutic outcomes including drug induced diseases (DIDs) and acute rejection (AR) induced by cyclosporine A were analyzed during the first year after conversion with SPSS17.0 software. Results The levels of Scr and BUN were significantly decreased during the first year after conversion for renal transplant patients with CScr and AR (P<0.05 or P<0.01). The levels of direct bilirubin (DB) and total bilirubin (TB) were also significantly lowed (P<0.05 or P<0.01) during the first year for drug-induced liver injury (DILI) patients. The average level of ALT was significantly decreased in 12 months after conversion (P<0.05). The complications of gingival overgrowth (GO) stopped with the medication replacement. However, the fasting blood glucose (FBG) level increased significantly in 12 months after conversion (P<0.05). Conclusion For renal transplant patients suffered from AR or the serious DIDs induced by cyclosporine A, conversion from cyclosporine A to tacrolimus could be considered. However, it should be aware of the high blood glucose or the new diabetes caused by tacrolimus.
  • [1] Halloran PF. Immunosuppressive drugs for kidney transplantation[J]. N Engl J Med, 2004,351(26):2715-2729.
    [2] Krämer BK, Montagnino G, Krüger B, et al. Efficacy and safety of tacrolimus compared with ciclosporin-A in renal transplantation:7-year observational results[J]. Transpl Int, 2016,29(3):307-314.
    [3] Ateyya H. Amelioration of cyclosporine induced nephrotoxicity by dipeptidyl peptidase inhibitor vildagliptin[J]. Int Immunopharmacol, 2015,28(1):571-577.
    [4] Nankivell BJ, Borrows RJ, Fung CL, et al. The natural history of chronic allograft nephropathy[J]. N Engl J Med, 2003, 349(24):2326-2333.
    [5] Gau CH, Tu HP, Chin YT, et al. Can chlorhexidine mouthwash twice daily ameliorate cyclosporine-induced gingival overgrowth?[J]. J Formos Med Assoc, 2013,112(3):131-137.
    [6] Wadei HM, Textor SC. Hypertension in the kidney transplant recipient[J]. Transplant Rev (Orlando), 2010,24(3):105-120.
    [7] Rezzani R. Cyclosporine A and adverse effects on organs:histochemical studies[J]. Prog Histochem Cytochem,2004,39(2):85-128.
    [8] Kamel M, Kadian M, Srinivas T, et al. Tacrolimus confers lower acute rejection rates and better renal allograft survival compared to cyclosporine[J].World J Transplant,2016, 6(4):697-702.
    [9] Franke GH, Trampenau C, Reimer J, et al. Switching from cyclosporine to tacrolimus leads to improved disease-specific quality of life in patients after kidney transplantation[J]. Transplant Proc, 2006,38(5):1293-1294.
    [10] Videla CO. Two-year experience with tacrolimus in renal transplantation after late conversion from cyclosporine therapy[J]. Transplant Proc, 2009,41(6):2659-2663.
    [11] Margreiter R, Pohanka E, Sparacino V, et al. Open prospective multicenter study of conversion to tacrolimus therapy in renal transplant patients experiencing ciclosporin-related side-effects[J]. Transpl Int, 2005,18(7):816-823.
    [12] 黄晓宁,陈小娟,李勇. 肾移植术后患者应用他克莫司与环孢素A发生急性排斥反应的Meta分析[J].中国医院用药评价与分析,2016,16(5):636-639.
    [13] Tao Y, Hu L, Li S, et al. Tranilast prevents the progression of chronic cyclosporine nephrotoxicity through regulation of transforming growth factor β/Smad pathways[J].Transplant Proc,2011,43(5):1985-1988.
    [14] Seeland S, Török M, Kettiger H, et al. A cell-based, multiparametric sensor approach characterises drug-induced cytotoxicity in human liver HepG2 cells[J]. Toxicol In Vitro, 2013,27(3):1109-1120.
    [15] Cond SAP, Bastos MG, Vieira BJ, et al. Down-regulation of transforming growth factor beta-2 expression is associated with the reduction of cyclosporin induced gingival overgrowth in rats treated with roxithromycin:an experimental study[J]. BMC Oral Health,2009,9(1):33.
    [16] Al-Hamilly NS, Radwan LR, Abdul-Rahman M, et al. Biological roles of KGF, CTGF and TGF-β in cyclosporine-A-and phenytoin-induced gingival overgrowth:A comparative experimental animal study.[J]. Arch Oral Biol,2016,66:38-43.
    [17] 余爱华,辛华雯,吴笑春,等.环孢素和他克莫司对肾移植后发生糖尿病的影响研究[J]. 中国药师, 2011,14(4):521-523.
    [18] Sinangil A, Celik V, Barlas S, et al. New-onset diabetes after kidney transplantation and pretransplant hypomagnesemia[J]. Prog Transplant, 2016, 26(1):55-61.
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A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus

doi: 10.3969/j.issn.1006-0111.2018.01.016
  • Department of Pharmacy, Changhai Hospital Affiliated to Second Military Medical University, Shanghai 200433, China
  • Received Date: 2017-02-20
  • Rev Recd Date: 2017-06-30

Abstract: Objective To study the efficacy and adverse reactions for renal transplant patients conversed from cyclosporine A to tacrolimus. Methods The follow-up data of renal transplant patients conversed from cyclosporine A to tacrolimus were collected. The clinical therapeutic outcomes including drug induced diseases (DIDs) and acute rejection (AR) induced by cyclosporine A were analyzed during the first year after conversion with SPSS17.0 software. Results The levels of Scr and BUN were significantly decreased during the first year after conversion for renal transplant patients with CScr and AR (P<0.05 or P<0.01). The levels of direct bilirubin (DB) and total bilirubin (TB) were also significantly lowed (P<0.05 or P<0.01) during the first year for drug-induced liver injury (DILI) patients. The average level of ALT was significantly decreased in 12 months after conversion (P<0.05). The complications of gingival overgrowth (GO) stopped with the medication replacement. However, the fasting blood glucose (FBG) level increased significantly in 12 months after conversion (P<0.05). Conclusion For renal transplant patients suffered from AR or the serious DIDs induced by cyclosporine A, conversion from cyclosporine A to tacrolimus could be considered. However, it should be aware of the high blood glucose or the new diabetes caused by tacrolimus.

WEI Zewu, ZHANG Wenwen, MA Duoling, BI Juan, CHEN Jiexiu, YANG Yunyun. A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(1): 75-79. doi: 10.3969/j.issn.1006-0111.2018.01.016
Citation: WEI Zewu, ZHANG Wenwen, MA Duoling, BI Juan, CHEN Jiexiu, YANG Yunyun. A retrospective analysis of the efficacy and adverse reactions for the renal transplant patients conversed from cyclosporine A to tacrolimus[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(1): 75-79. doi: 10.3969/j.issn.1006-0111.2018.01.016
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