Impact of cyclosporine reduction with MMF: a randomized trial in chronic allograft dysfunction. The 'reference' study. - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles American Journal of Transplantation Year : 2006

Impact of cyclosporine reduction with MMF: a randomized trial in chronic allograft dysfunction. The 'reference' study.

Abstract

Long-term use of calcineurine inhibitors (CNIs) may contribute to the development of chronic allograft dysfunction (CAD). We investigate the impact of the introduction of MMF combined with cyclosporine (CsA) 50% dose reduction. An open, randomized, controlled, multicenter, prospective study was conducted in 103 patients, receiving a CsA-based therapy with a serum creatinine between 1.7-3.4 mg/dL, more than 1 year after transplantation. They were randomized to receive MMF with half dose of CsA (MMF group) or to continue their maintenance CsA dose (control group). A total of 96 weeks after randomization, the evolution of renal function assessed by regression line analysis of 1/SeCr improved in the MMF group (positive slope) vs. the control group (negative slope), 4.2 x 10(-4) vs. -3.0 x 10(-4), respectively (p < 0.001). Concurrently, the absolute renal function improved significantly in the MMF group. No episode of biopsy-proven acute rejection occurred. One patient in each group lost his graft because of biopsy-proven chronic allograft nephropathy. There was a significant decrease of triglycerides level in the MMF group. Anemia and diarrhea were statistically more frequent in the MMF group. In CAD, the reduction of CsA in the presence of MMF results in significant improvement in renal function during a 2-year follow-up.

Domains

Immunology

Dates and versions

inserm-00473412 , version 1 (15-04-2010)

Identifiers

Cite

Luc Frimat, Elisabeth Cassuto-Viguier, Bernard Charpentier, Christian Noël, François Provôt, et al.. Impact of cyclosporine reduction with MMF: a randomized trial in chronic allograft dysfunction. The 'reference' study.. American Journal of Transplantation, 2006, 6 (11), pp.2725-34. ⟨10.1111/j.1600-6143.2006.01535.x⟩. ⟨inserm-00473412⟩
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