safety of immunosuppressive drugs used as maintenance therapy in kidney transplantation: a systematic review and meta-analysis
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2013
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Abstract
To evaluate the safety of regimens containing calcineurin inhibitors (CNI), proliferation signal inhibitors (TOR-I) and antimetabolites, we conducted a meta-analysis of randomized clinical trials (RCTs) and observational studies. A total of 4,960 citations were identified in our electronic search and 14 additional articles were identified through hand searching. Forty-eight articles (11,432 participants) from 42 studies (38 RCTs and four cohorts) met the inclusion criteria. Meta-analysis results revealed the following: (i) tacrolimus was associated with an increased risk for diabetes and lower risk of dyslipidemia, compared to cyclosporine; (ii) mycophenolate mofetil (MMF) was associated with increased risk for total infections, abdominal pain, diarrhea and vomiting, compared with azathioprine; (iii) sirolimus was associated with higher risk of anemia, diabetes, dyslipidemia, lymphoceles and withdrawal compared to tacrolimus or cyclosporine, and cyclosporine was associated with an increased risk of CMV infection; (iv) the combination of CNI with antimetabolites was associated with more adverse events than CNI alone; (v) TOR-I was related to more adverse events than MMF. The data observed in this meta-analysis are similar to those describe by others authors; thus, the choice of treatment must be made by the clinical staff based on specific patient characteristics.
| Reference Key |
almeida2013pharmaceuticalssafety
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|---|---|
| Authors | ;Celline Cardoso Almeida;Micheline Rosa Silveira;Vânia Eloisa de Araújo;Livia Lovato Pires de Lemos;Juliana de Oliveira Costa;Carlos Augusto Lins Reis;Francisco de Assis Acurcio;Maria das Gracas Braga Ceccato |
| Journal | journal of cerebral blood flow and metabolism |
| Year | 2013 |
| DOI |
10.3390/ph6101170
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| URL | |
| Keywords |
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