When certain immunosuppressive drugs are withdrawn after kidney transplantation, patients can experience prolonged survival and save a significant amount of money when compared to patients on these medications for life.
The finding was disclosed in a study that appeared in an issue of the Journal of the American Society Nephrology (JASN).
From Medicalnewstoday.com:
Sirolimus, in combination with steroids, is currently the only immunosuppressive treatment regimen that is approved for use when calcineurin inhibitors are withdrawn. Therefore, Dr. Earnshaw's group compared treatments containing sirolimus plus steroids versus treatments that maintained the use of calcineurin inhibitors.
The researchers' decision-analytic model, using data published in the literature and reported by the US transplant registry, assumed that within the first 12 months following transplant surgery, sirolimus plus steroid therapy is associated with a greater risk of kidney allograft rejection than regimens that continue to use calcineurin inhibitors. Other commonly used regimens include a calcineurin inhibitor such as cyclosporine or tacrolimus, plus mycophenolate mofetil and steroids. In this particular study, it was assumed that in the absence of induction therapy a total of 21.8% of patients taking sirolimus plus steroids experienced acute rejection within one year of transplantation, compared with 19.0% of patients taking cyclosporine plus mycophenolate mofetil and steroids, and 17.1% of patients taking tacrolimus plus mycophenolate mofetil and steroids.
However, it was revealed that overall, treatment with sirolimus plus steroids may be more efficacious and less costly than regimens that continued to use calcineurin inhibitors. Specifically, withdrawal of calcineurin inhibitors may prolong patients' lives and improve their kidney function.
Wyeth Pharmaceuticals in Collegeville, PA, provided funding for this analysis.
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