Immunosuppressant Regimen Based on Sirolimus Decreases Aortic Stiffness in Renal Transplant Recipients in Comparison to Cyclosporine.
Joannides R. Monteil C et al.American Journal of Transplantation. 11(11): 2414-22, 2011.
Aims
To evaluate whether sirolimus based immunosuppressant regimen can confer beneficial effect on arterial stiffness and central blood pressure in renal transplant recipients.
Interventions
Convert Cyclosporine (CSA) to sirolimus at week 12 versus continued CSA. All patients received a humanized anti-IL2 receptor monoclonal antibody.
Participants
44 de novo kidney transplant recipients from the CONCEPT trial.
Outcomes
Outcome measurements were systemic and central homodynamic parameters, biological parameters and aotic stiffness measurement. Homodynamic parameters included systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure and augmentation pressure. Biological parameters included low density lipoprotein, high density lipoprotein, glomerular filtration rate, total cholesterol, triglycerides and plasma glucose.
Follow-up
3 months.
CET Conclusions
In this cohort of 44 patients from the CONCEPT trial who were either switched from CSA to sirolimus at week 12 or continued on CSA, there was evidence that the patients switched to sirolimus had a reduction in aortic stiffness, plasma endothelin-1 and oxidative stress. The authors suggest that this might represent a protective effect on the arterial wall and which therefore might possibly reduce cardiovascular risk.
Data analysis
Strict intention-to-treat analysis
Quality notes
Reporting Quality: This is a subgroup study of an original publication: Lebranchu Y, Thierry A, Toupance O, et al. Efficacy on renal function of early conversion from cyclosporine to sirolimus 3 months after renal transplantation: Concept study. Am J Transplant 2009; 9: 1115–1123. The quality assessment was based on the original paper. Data analysis for this subgroup study is per-protocol analysis
Trial registration
Eudract-No. 2004–002987-62