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http://hdl.handle.net/2445/134284
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DC Field | Value | Language |
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dc.contributor.author | Ekberg, Henrik | - |
dc.contributor.author | Tedesco Silva, Hélio | - |
dc.contributor.author | Demirbas, Alper | - |
dc.contributor.author | Vitko, Stefan | - |
dc.contributor.author | Nashan, Björn | - |
dc.contributor.author | Gürkan, Alp | - |
dc.contributor.author | Margreiter, Raimund | - |
dc.contributor.author | Hugo, Christian | - |
dc.contributor.author | Grinyó Boira, Josep M. | - |
dc.contributor.author | Frei, Ulrich | - |
dc.contributor.author | Vanrenterghem, Yves | - |
dc.contributor.author | Daloze, Pierre | - |
dc.contributor.author | Halloran, Philip F. | - |
dc.date.accessioned | 2019-05-31T13:18:59Z | - |
dc.date.available | 2019-05-31T13:18:59Z | - |
dc.date.issued | 2007-12-20 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.uri | http://hdl.handle.net/2445/134284 | - |
dc.description.abstract | Background: immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. Methods: we randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. Results: the mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). Conclusions: a regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. | - |
dc.format.extent | 14 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Massachusetts Medical Society | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1056/NEJMoa067411 | - |
dc.relation.ispartof | New England Journal of Medicine, 2007, vol. 357, num. 25, p. 2562-2575 | - |
dc.relation.uri | https://doi.org/10.1056/NEJMoa067411 | - |
dc.rights | (c) Massachusetts Medical Society, 2007 | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Corticosteroides | - |
dc.subject.classification | Ús terapèutic | - |
dc.subject.classification | Inhibidors enzimàtics | - |
dc.subject.classification | Posologia | - |
dc.subject.classification | Rebuig (Biologia) | - |
dc.subject.classification | Immunosupressors | - |
dc.subject.classification | Trasplantament renal | - |
dc.subject.other | Adrenocortical hormones | - |
dc.subject.other | Therapeutic use | - |
dc.subject.other | Enzyme inhibitors | - |
dc.subject.other | Posology | - |
dc.subject.other | Graft rejection | - |
dc.subject.other | Immunosupressive agents | - |
dc.subject.other | Kidney transplantation | - |
dc.title | Reduced exposure to calcineurin inhibitors in renal transplantation | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 567541 | - |
dc.date.updated | 2019-05-31T13:18:59Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 18094377 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
Files in This Item:
File | Description | Size | Format | |
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567541.pdf | 303.14 kB | Adobe PDF | View/Open |
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