Abstract

RODRIGUES, Luís et al. Conversion from twice-daily tacrolimus to an extended release formulation in stable kidney transplant recipients: 2-year follow-up results of a single centre. Port J Nephrol Hypert [online]. 2015, vol.29, n.1, pp.39-43. ISSN 0872-0169.

Introduction: Calcineurin inhibitors are currently considered the cornerstone of maintenance immunosuppression in renal transplantation. The extended release formulation of tacrolimus (ER-TAC) was developed to improve drug adherence in these patients. The long-term safety and efficacy of the conversion from the twice-daily tacrolimus to the ER-TAC is still undetermined. Subjects and Methods: Retrospective registry-based single centre study including all renal transplant recipients converted from TAC twice-daily to the ER-TAC on a 1: 1 mg basis. We collected biometric data, induction regimens, acute rejection episodes and death. Variables of interest [serum creatinine, blood urea nitrogen, fasting glucose, urinalysis, haemoglobin, TAC dose (mg/kg) and TAC trough levels (ng/ml)] were registered at conversion and 1, 6, 12 months and at last follow-up post-conversion. Results: We analysed 127 patients, 71.9 % male, mean age at conversion (± SD) was 49.8 ± 13.6 years. Conversion occurred at 4.10 ± 3.83 years after transplant and our mean follow-up time was 2.56 ± 0.55 years. TAC trough levels (ng/ml) progressively decreased from pre-conversion to the following stages (pre-conversion: 7.41 ± 2.61 vs. last followup: 5.04 ± 1.86, p < 0.001) but no significant dose adjustments were necessary for attaining predetermined target levels. Renal function remained stable and there were no significant differences in glucose metabolism pre and post conversion. No significant adverse effects were verified. There were no episodes of acute rejection throughout the follow-up. Conclusions: The conversion to ER-TAC ensured effective immunosuppression over a follow-up of 2 years suggesting that this formulation is an excellent alternative to the conventional one

Keywords : Conversion; extended release; immunosuppression; renal transplantation; tacrolimus.

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