efficacy and safety of low-dose everolimus as maintenance immunosuppression in cardiac transplant recipients疗效和安全性的低剂量everolimus维护心脏移植受者的免疫抑制.pdfVIP

Hindawi Publishing Corporation Journal of Transplantation Volume 2012, Article ID 976921, 7 pages doi:10.1155/2012/976921 Clinical Study Efficacy and Safety of Low-Dose Everolimus as Maintenance Immunosuppression in Cardiac Transplant Recipients Uwe Fuchs, Armin Zittermann, Uwe Schulz, and Jan F. Gummert Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany Correspondence should be addressed to Armin Zittermann, azittermann@hdz-nrw.de Received 24 August 2011; Accepted 14 February 2012 Academic Editor: Waldo Concepcion Copyright © 2012 Uwe Fuchs et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. For cardiac transplant (CTx) recipients, the recommended everolimus (EVL) dose is 0.75 mg bid or 1.5 mg bid and the target trough blood level is 3–8 µg/L. We studied a cohort of 56 CTx patients with chronic kidney disease receiving 0.75 mg bid EVL to maintain blood levels of 5–8 ug/L (designated RD group) and a cohort of 51 CTx patients with chronic kidney disease receiving 0.5 mg bid to maintain blood levels of 3–5 ug/L (designated LD group). The primary endpoint was a composite of death, rejection and premature EVL discontinuation up to 1 year after introduction of EVL. The primary endpoint was reached by 32% of patients in the LD group and by 41.1% of patients in the RD group (P = 0.361). Biochemical safety parameters were comparable in both groups. Our results indicate that low-dose EVL may be as effective and safe as regular dose EVL. 1. Introduction