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Journal articles
Efficacy and safety of early cyclosporine conversion to sirolimus with continued MMF-four-year results of the Postconcept study.
Yvon Lebranchu
1
A. Thierry
2
Etienne Thervet
3
M. Büchler
1
I. Etienne
4
P. F. Westeel
5
B. Hurault de Ligny
6
B. Moulin
7
Jean-Philippe Rerolle
8
T. Frouget
9
S. Girardot-Seguin
10
Olivier Toupance
11
10
Roche SAS
Jean-Philippe Rerolle 8
Author
T. Frouget 9
Author
S. Girardot-Seguin 10
Author
Olivier Toupance 11
Author
1
Service de néphrologie et immunologie clinique (Tours - France)
- CHRU Tours - Centre Hospitalier Régional Universitaire de Tours (France)
- Université de Tours (60 rue du Plat d'Étain, 37020 Tours cedex 1 - France)
2
Service de néphrologie - hémodialyse et transplantation rénale (Poitiers - France)
- CHU Poitiers - Centre hospitalier universitaire de Poitiers (2 Rue de la Milétrie, 86021 Poitiers - France)
3
Service de néphrologie adultes [CHU Necker] (149 Rue de Sèvres, 75015 Paris - France)
- CHU Necker - Enfants Malades [AP-HP] (149 Rue de Sèvres 75015 Paris - France)
- AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) (France)
4
Service de Néphrologie [Rouen] (1 Avenue de Germont 76031 Rouen Cedex - France)
- CHU Rouen (1, rue de Germont 76031 Rouen cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- UNIROUEN - Université de Rouen Normandie (1, rue Thomas Becket 76821 Mont-Saint-Aignan Cedex - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
5
Service de dyalise et transplantation (Amiens - France)
- UPJV - Université de Picardie Jules Verne (Chemin du Thil - 80000 Amiens - France)
- CHU Amiens-Picardie (France)
6
Service de Néphrologie-Dialyse-Transplantation rénale [CHU Caen] (Centre Hospitalier Universitaire
Avenue de la Côte de Nacre
CS 30001
14033 CAEN cedex 9 - France)
- UNICAEN - Université de Caen Normandie (Esplanade de la Paix - CS 14032 - 14032 CAEN Cedex 5 - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- CHU Caen (Avenue de la Côte de Nacre 14000 Caen - France)
- NU - Normandie Université (Esplanade de la Paix - CS 14032 - 14032 Caen Cedex 5 - France)
- TCBN - Tumorothèque de Caen Basse-Normandie (3 avenue du Général Harris 14076 Caen cedex 5 - France)
8
Service de Néphrologie, Dialyse, Transplantations [CHU Limoges] (Centre Hospitalier Universitaire Dupuytren 2, avenue Martin Luther King 87042 Limoges cedex - France)
- CHU Limoges (Centre Hospitalier Universitaire Dupuytren - 2 avenue Martin Luther King 87042 LIMOGES - France)
9
Service de néphrologie (35033 Rennes - France)
- UR1 - Université de Rennes 1 (2 rue du Thabor - CS 46510 - 35065 Rennes cedex - France)
- UNIV-RENNES - Université de Rennes (France)
- Hôpital Pontchaillou (France)
- CHU Pontchaillou [Rennes] (2 Rue Henri le Guilloux, 35000 Rennes - France)
11
service de néphrologie et transplantation (Reims - France)
- CHU Reims - Centre Hospitalier Universitaire de Reims (45, rue Cognacq-Jay 51100 Reims - France)
Abstract : Calcineurin inhibitor (CNI) withdrawal has been used as a strategy to improve renal allograft function. We previously reported that conversion from cyclosporine A (CsA) to sirolimus (SRL) 3 months after transplantation significantly improved renal function at 1 year. In the Postconcept trial, 77 patients in the SRL group and 85 in the CsA group were followed for 48 months. Renal function (Cockcroft and Gault) was significantly better at month 48 (M48) in the SRL group both in the intent-to-treat population (ITT): 62.6 mL/min/1.73 m(2) versus 57.1 mL/min/1.73 m(2) (p = 0.013) and in the on-treatment population (OT): 67.5 mL/min/1.73 m(2) versus 57.4 mL/min/1.73 m(2) (p = 0.002). Two biopsy proven acute rejection episodes occurred after M12 in each group. Graft and patient survival were comparable (graft survival: 97.4 vs. 100%; patient survival: 97.4 vs. 97.6%, respectively). The incidence of new-onset diabetes was numerically increased in the SRL group (7 vs. 2). In OT, three cancers occurred in the SRL group versus nine in the CsA group and mean proteinuria was increased in the SRL group (0.42 ± 0.44 vs. 0.26 ± 0.37; p = 0.018). In summary, the renal benefits associated with conversion of CsA to SRL, at 3 months posttransplantation, in combination with MMF were maintained for 4 years posttransplantation.
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Journal articles
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https://www.hal.inserm.fr/inserm-00926380
Contributor : Pierre Marquet <>
Submitted on : Thursday, January 9, 2014 - 3:04:35 PM
Last modification on : Wednesday, August 19, 2020 - 11:16:41 AM
Contributor : Pierre Marquet <>
Submitted on : Thursday, January 9, 2014 - 3:04:35 PM
Last modification on : Wednesday, August 19, 2020 - 11:16:41 AM
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- HAL Id : inserm-00926380, version 1
- DOI : 10.1111/j.1600-6143.2011.03637.x
- PUBMED : 21797975
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Yvon Lebranchu, A. Thierry, Etienne Thervet, M. Büchler, I. Etienne, et al.. Efficacy and safety of early cyclosporine conversion to sirolimus with continued MMF-four-year results of the Postconcept study.. American Journal of Transplantation, Wiley, 2011, 11 (8), pp.1665-75. ⟨10.1111/j.1600-6143.2011.03637.x⟩. ⟨inserm-00926380⟩
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