Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial

This is an 18-month prospective, randomized controlled trial (RCT) designed to compare the effect of early conversion from cyclosporin to everolimus/mycophenolic acid (E-MPA) between 3 and 4 months post-transplant to cyclosporin/mycophenolic acid (CsA-MPA) on left ventricular mass index (LVMI) at 3...

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Main Authors: Krishnan, A., Teixeira-Pinto, A., Chan, D., Chakera, Aron, Dogra, G., Boudville, N., Irish, A., Morgan, K., Phillips, J., Wong, G., Lim, W.
Format: Journal Article
Published: 2017
Online Access:http://hdl.handle.net/20.500.11937/56971
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author Krishnan, A.
Teixeira-Pinto, A.
Chan, D.
Chakera, Aron
Dogra, G.
Boudville, N.
Irish, A.
Morgan, K.
Phillips, J.
Wong, G.
Lim, W.
author_facet Krishnan, A.
Teixeira-Pinto, A.
Chan, D.
Chakera, Aron
Dogra, G.
Boudville, N.
Irish, A.
Morgan, K.
Phillips, J.
Wong, G.
Lim, W.
author_sort Krishnan, A.
building Curtin Institutional Repository
collection Online Access
description This is an 18-month prospective, randomized controlled trial (RCT) designed to compare the effect of early conversion from cyclosporin to everolimus/mycophenolic acid (E-MPA) between 3 and 4 months post-transplant to cyclosporin/mycophenolic acid (CsA-MPA) on left ventricular mass index (LVMI) at 3 and 18 months post-transplant (primary outcome). Secondary outcomes included estimated glomerular filtration rate (eGFR), viral infection, and adverse events. Twenty-four patients were randomized in a 1:1 ratio to E-MPA or CsA-MPA groups. There were no significant differences in mean (SD) LVMI at 3 (51.6±18.5 vs 53.7±15.7 g/m 2.7 ) and 18 months (52.7±16.3 vs 51.7±16.8 g/m 2.7 ) between CsA-MPA and E-MPA groups. The incidence of viral infections was reduced in E-MPA compared to CsA-MPA treatment groups (8% vs 50%, P=.02), but the incidences of acute rejection, adverse events, and drug discontinuation were similar between groups. There was an overall increase in eGFR with time (0.04 log- mL/min/1.73 m 2 per 6 months, P=.012) but no significant difference between the two groups across time (0.11 log- mL/min/1.73 m 2 , P=.311). Immunosuppressive regimen comprising early conversion from cyclosporine to everolimus was not associated with a regression of LVMI, but a lower risk of viral infections was observed.
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spelling curtin-20.500.11937-569712018-01-15T03:39:14Z Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial Krishnan, A. Teixeira-Pinto, A. Chan, D. Chakera, Aron Dogra, G. Boudville, N. Irish, A. Morgan, K. Phillips, J. Wong, G. Lim, W. This is an 18-month prospective, randomized controlled trial (RCT) designed to compare the effect of early conversion from cyclosporin to everolimus/mycophenolic acid (E-MPA) between 3 and 4 months post-transplant to cyclosporin/mycophenolic acid (CsA-MPA) on left ventricular mass index (LVMI) at 3 and 18 months post-transplant (primary outcome). Secondary outcomes included estimated glomerular filtration rate (eGFR), viral infection, and adverse events. Twenty-four patients were randomized in a 1:1 ratio to E-MPA or CsA-MPA groups. There were no significant differences in mean (SD) LVMI at 3 (51.6±18.5 vs 53.7±15.7 g/m 2.7 ) and 18 months (52.7±16.3 vs 51.7±16.8 g/m 2.7 ) between CsA-MPA and E-MPA groups. The incidence of viral infections was reduced in E-MPA compared to CsA-MPA treatment groups (8% vs 50%, P=.02), but the incidences of acute rejection, adverse events, and drug discontinuation were similar between groups. There was an overall increase in eGFR with time (0.04 log- mL/min/1.73 m 2 per 6 months, P=.012) but no significant difference between the two groups across time (0.11 log- mL/min/1.73 m 2 , P=.311). Immunosuppressive regimen comprising early conversion from cyclosporine to everolimus was not associated with a regression of LVMI, but a lower risk of viral infections was observed. 2017 Journal Article http://hdl.handle.net/20.500.11937/56971 10.1111/ctr.13043 restricted
spellingShingle Krishnan, A.
Teixeira-Pinto, A.
Chan, D.
Chakera, Aron
Dogra, G.
Boudville, N.
Irish, A.
Morgan, K.
Phillips, J.
Wong, G.
Lim, W.
Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title_full Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title_fullStr Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title_full_unstemmed Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title_short Impact of early conversion from cyclosporin to everolimus on left ventricular mass index: A randomized controlled trial
title_sort impact of early conversion from cyclosporin to everolimus on left ventricular mass index: a randomized controlled trial
url http://hdl.handle.net/20.500.11937/56971