High‐dose mizoribine combined with calcineurin inhibitor (cyclosporine or tacrolimus), basiliximab and corticosteroids for renal transplantation: A Japanese multicenter study. (25th October 2017)

• Record Type: Journal Article
• Authors: Nishioka, Tsukasa; Yoshimura, Norio; Ushigome, Hidetaka; Watarai, Yoshihiko; Nishimura, Kenji; Akioka, Kiyokazu; Nakamura, Nobuyuki; Kawakita, Mutsushi; Yuzawa, Kenji; Nakatani, Tatsuya
• Is Part Of: International journal of urology. Volume 25:Number 2(2018)
• Page Start: 141
• Page End: 145
• Publication Date: 2017-10-25
• Subjects: calcineurin inhibitors -- combination therapy -- cytomegalovirus -- mizoribine -- renal transplantation; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.13476
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objective: To evaluate the utility and safety of high‐dose mizoribine combination therapy using cyclosporine and tacrolimus as calcineurin inhibitors in patients undergoing kidney transplant. Methods: The present study enrolled 156 patients who received kidney transplants in 18 institutions between 2009 and 2013. ABO‐incompatible and/or pre‐sensitized recipients were excluded. Immunosuppression used cyclosporine (88) or tacrolimus (68) as a calcineurin inhibitor, and the dosage was adjusted based on blood concentrations. Mizoribine was started at 6 mg/kg/day, and the target trough level was 1–2 ng/mL. Primary efficacy end‐points of this study were 2‐year patient survival, 2‐year graft survival and the acute rejection rate within 2 years after transplantation. Results: The 2‐year patient and graft survival rates in the cyclosporine group were 98.9% and 94.3%, respectively, whereas those in the tacrolimus group were 100% and 98.5%, respectively, with no significant difference between groups. Rates of onset of rejection during the observation period were also equivalent, at 22.7% in the cyclosporine group and 17.6% in the tacrolimus group. Furthermore, groups showed no significant differences in transplanted renal function. No notable differences in adverse events were observed between groups. Conclusions: A regimen of high‐dose mizoribine in combination with calcineurin inhibitors basiliximab, and corticosteroids can provide effective immunosuppression while lowering the rate of cytomegalovirus infection in kidney transplant patients.