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• W2126870378 abstract "Calcineurin-inhibitor-sparing strategies in kidney transplantation may spare patients the adverse effects of these drugs, but the efficacy of these strategies is unknown. Here, we conduct a meta-analysis to assess outcomes associated with reducing calcineurin inhibitor exposure from the time of transplantation. We search Medline, Embase, and Cochrane Register of Controlled Trials for randomized controlled trials published between 1966 and 2010 that compared de novo calcineurin-inhibitor-sparing regimens to calcineurin-inhibitor-based regimens. In this analysis, we include 56 studies comprising data from 11337 renal transplant recipients. Use of the contemporary agents belatacept or tofacitinib, in combination with mycophenolate, decreased the odds of overall graft failure (OR 0.61; 95% CI 0.39-0.96; P = 0.03). Similarly, minimization of calcineurin inhibitors in combination with various induction and adjunctive agents reduces the odds of graft failure (OR 0.73; 95% CI 0.58-0.92; P = 0.009). Conversely, the use of inhibitors of mammalian target of rapamycin (mTOR), in combination with mycophenolate, increases the odds of graft failure (OR 1.43; 95% CI 1.08-1.90; P = 0.01). Calcineurin-inhibitor-sparing strategies are associated with less delayed graft function (OR 0.89; 95% CI 0.80-0.98; P = 0.02), improved graft function, and less new-onset diabetes. The more contemporary protocols did not seem to increase rates of acute rejection. In conclusion, this meta-analysis suggests that reducing exposure to calcineurin inhibitors immediately after kidney transplantation may improve clinical outcomes." @default.
• W2126870378 created "2016-06-24" @default.
• W2126870378 creator A5000172660 @default.
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• W2126870378 creator A5043992397 @default.
• W2126870378 creator A5083113170 @default.
• W2126870378 date "2011-09-23" @default.
• W2126870378 modified "2023-10-15" @default.
• W2126870378 title "Meta-Analysis of Calcineurin-Inhibitor-Sparing Regimens in Kidney Transplantation" @default.
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• W2126870378 doi "https://doi.org/10.1681/asn.2010111160" @default.
• W2126870378 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3280000" @default.
• W2126870378 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21949096" @default.
• W2126870378 hasPublicationYear "2011" @default.
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