Evidence-based practice: guidance for using everolimus in combination with low-exposure calcineurin inhibitors as initial immunosuppression in kidney transplant patients

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• dc.contributor.author Pascual Santos, Julio
• dc.contributor.author Berger, Stefan
• dc.contributor.author Chadban, Steven J.
• dc.contributor.author Citterio, Franco
• dc.contributor.author Kamar, Nassim
• dc.contributor.author Hesselink, Dennis A.
• dc.contributor.author Legendre, Christophe
• dc.contributor.author Eisenberger, Ute
• dc.contributor.author Oppenheimer, Federico
• dc.contributor.author Russ,Graeme R.
• dc.contributor.author Sommerer, Claudia
• dc.contributor.author Rigotti, Paolo
• dc.contributor.author Srinivas, Titte R.
• dc.contributor.author Watarai, Yoshihiko
• dc.contributor.author Henry, Mitchell L.
• dc.contributor.author Vincenti, Flavio
• dc.contributor.author Tedesco-Silva, Helio
• dc.date.accessioned 2020-05-04T07:14:53Z
• dc.date.issued 2019
• dc.description.abstract The mammalian target of rapamycin (mTOR) inhibitor, everolimus, in combination with reduced-exposure calcineurin inhibitor (CNI), has been demonstrated in clinical trials to have comparable efficacy in low-to-moderate immunological risk kidney transplant recipients to the Standard of Care, mycophenolic acid (MPA) in combination with standard-exposure CNI. Current treatment guidelines consider mTOR inhibitors to be a second-line therapy in the majority of cases; however, given that everolimus-based regimens are associated with a reduced rate of viral infections after transplantation, their wider use could have great benefits for kidney transplant patients. In this evidence-based practice guideline, we consider the de novo use of everolimus in kidney transplant recipients. The main outcomes of our consideration of the available evidence are that: 1. Everolimus, in combination with reduced-exposure CNI and low dose steroids, is a suitable regimen for the prophylaxis of kidney transplant rejection in the majority of low-to-moderate immunological risk adult patients, with individualized management; 2. Induction with either basiliximab or rabbit anti-thymocyte globulin is an effective therapy for kidney transplant recipients when initiating an everolimus-based, reduced-exposure CNI regimen; and 3. An individualized approach should be adopted when managing kidney transplant recipients on everolimus-based therapy.
• dc.format.mimetype application/pdf
• dc.identifier.citation Pascual J, Berger SP, Chadban SJ, Citterio F, Kamar N, Hesselink DA, et al. Evidence-based practice: guidance for using everolimus in combination with low-exposure calcineurin inhibitors as initial immunosuppression in kidney transplant patients. Transplant Rev (Orlando). 2019 Oct;33(4):191-9. DOI: 10.1016/j.trre.2019.07.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.trre.2019.07.001
• dc.identifier.issn 0955-470X
• dc.identifier.uri http://hdl.handle.net/10230/44385
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.trre.2019.07.001
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Everolimus
• dc.subject.keyword Guidelines
• dc.subject.keyword Kidney
• dc.subject.keyword Transplantation
• dc.subject.keyword mTOR inhibitor/mTORi
• dc.title Evidence-based practice: guidance for using everolimus in combination with low-exposure calcineurin inhibitors as initial immunosuppression in kidney transplant patients
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion