Fan Ye1, Xiao Ying-Bin, Weng Yu-Guo, Roland Hetzer. 1. Department of Cardiothoracic and Vascular Surgery, Chongqing Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Abstract
BACKGROUND: Tacrolimus and cyclosporine microemulsion are the 2 major immunosuppressants for heart transplantation. Several studies have compared these 2 drugs, but the outcomes were not consistent. This meta-analysis of randomized controlled trials compared the beneficial and harmful effects of tacrolimus and microemulsion cyclosporine for heart transplant recipients. METHODS: Electronic databases and manual bibliography searches were conducted. A meta-analysis was performed of all randomized controlled trials comparing tacrolimus with cyclosporine microemulsion as primary immunosuppression for heart transplant recipients. Data for mortality, acute rejection, withdrawals, and adverse events were extracted. The combined results of the data of the randomized controlled trials were summarized as relative risk with 95% confidence intervals. RESULTS: The study assessed 7 randomized controlled trials including 885 patients. There was no difference in mortality at 1 year between recipients treated with tacrolimus and cyclosporine microemulsion. Tacrolimus-treated patients had less acute rejection risk at 6 months and 1 year. Fewer patients stopped tacrolimus than cyclosporine microemulsion. The rate of new-onset diabetes mellitus requiring insulin treatment was higher with tacrolimus. More post-transplantation hypertension occurred with cyclosporine microemulsion. The groups had comparable incidences of malignancy and renal failure needing dialysis. CONCLUSIONS: The use of tacrolimus as primary immunosuppressant for heart transplant recipients results in comparable survival and a significant reduction in acute rejection compared with cyclosporine microemulsion.
BACKGROUND:Tacrolimus and cyclosporine microemulsion are the 2 major immunosuppressants for heart transplantation. Several studies have compared these 2 drugs, but the outcomes were not consistent. This meta-analysis of randomized controlled trials compared the beneficial and harmful effects of tacrolimus and microemulsion cyclosporine for heart transplant recipients. METHODS: Electronic databases and manual bibliography searches were conducted. A meta-analysis was performed of all randomized controlled trials comparing tacrolimus with cyclosporine microemulsion as primary immunosuppression for heart transplant recipients. Data for mortality, acute rejection, withdrawals, and adverse events were extracted. The combined results of the data of the randomized controlled trials were summarized as relative risk with 95% confidence intervals. RESULTS: The study assessed 7 randomized controlled trials including 885 patients. There was no difference in mortality at 1 year between recipients treated with tacrolimus and cyclosporine microemulsion. Tacrolimus-treated patients had less acute rejection risk at 6 months and 1 year. Fewer patients stopped tacrolimus than cyclosporine microemulsion. The rate of new-onset diabetes mellitus requiring insulin treatment was higher with tacrolimus. More post-transplantation hypertension occurred with cyclosporine microemulsion. The groups had comparable incidences of malignancy and renal failure needing dialysis. CONCLUSIONS: The use of tacrolimus as primary immunosuppressant for heart transplant recipients results in comparable survival and a significant reduction in acute rejection compared with cyclosporine microemulsion.
Authors: Michelle R Denburg; Madhura Pradhan; Justine Shults; Abigail Jones; Jo Ann Palmer; H Jorge Baluarte; Mary B Leonard Journal: Pediatr Nephrol Date: 2010-06-22 Impact factor: 3.714
Authors: Luit Penninga; Christian H Møller; Finn Gustafsson; Daniel A Steinbrüchel; Christian Gluud Journal: Eur J Clin Pharmacol Date: 2010-09-30 Impact factor: 2.953
Authors: Matthias Helmschrott; Rasmus Rivinius; Arjang Ruhparwar; Bastian Schmack; Christian Erbel; Christian A Gleissner; Mohammadreza Akhavanpoor; Lutz Frankenstein; Philipp Ehlermann; Tom Bruckner; Hugo A Katus; Andreas O Doesch Journal: Drug Des Devel Ther Date: 2015-02-24 Impact factor: 4.162
Authors: Rasmus Rivinius; Matthias Helmschrott; Arjang Ruhparwar; Bastian Schmack; Berthold Klein; Christian Erbel; Christian A Gleissner; Mohammadreza Akhavanpoor; Lutz Frankenstein; Fabrice F Darche; Dierk Thomas; Philipp Ehlermann; Tom Bruckner; Hugo A Katus; Andreas O Doesch Journal: Drug Des Devel Ther Date: 2014-12-17 Impact factor: 4.162
Authors: Matthias Helmschrott; Rasmus Rivinius; Thomas Bruckner; Hugo A Katus; Andreas O Doesch Journal: Drug Des Devel Ther Date: 2017-06-07 Impact factor: 4.162
Authors: Matthias Helmschrott; Jan Beckendorf; Ceylan Akyol; Arjang Ruhparwar; Bastian Schmack; Christian Erbel; Christian A Gleissner; Mohammadreza Akhavanpoor; Philipp Ehlermann; Tom Bruckner; Hugo A Katus; Andreas O Doesch Journal: Drug Des Devel Ther Date: 2014-09-09 Impact factor: 4.162