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Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis
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 an...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817604/ https://www.ncbi.nlm.nih.gov/pubmed/24275847 http://dx.doi.org/10.3390/ph6101170 |
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author | Almeida, Celline Cardoso Silveira, Micheline Rosa de Araújo, Vânia Eloisa de Lemos, Livia Lovato Pires de Oliveira Costa, Juliana Reis, Carlos Augusto Lins de Assis Acurcio, Francisco Braga Ceccato, Maria das Gracas |
author_facet | Almeida, Celline Cardoso Silveira, Micheline Rosa de Araújo, Vânia Eloisa de Lemos, Livia Lovato Pires de Oliveira Costa, Juliana Reis, Carlos Augusto Lins de Assis Acurcio, Francisco Braga Ceccato, Maria das Gracas |
author_sort | Almeida, Celline Cardoso |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-3817604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-38176042013-11-14 Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis Almeida, Celline Cardoso Silveira, Micheline Rosa de Araújo, Vânia Eloisa de Lemos, Livia Lovato Pires de Oliveira Costa, Juliana Reis, Carlos Augusto Lins de Assis Acurcio, Francisco Braga Ceccato, Maria das Gracas Pharmaceuticals (Basel) Review 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. MDPI 2013-09-30 /pmc/articles/PMC3817604/ /pubmed/24275847 http://dx.doi.org/10.3390/ph6101170 Text en © 2013 by the authors; licensee MDPI, Basel, Switzerland. http://creativecommons.org/licenses/by/3.0/ This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/). |
spellingShingle | Review Almeida, Celline Cardoso Silveira, Micheline Rosa de Araújo, Vânia Eloisa de Lemos, Livia Lovato Pires de Oliveira Costa, Juliana Reis, Carlos Augusto Lins de Assis Acurcio, Francisco Braga Ceccato, Maria das Gracas Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title | Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title_full | Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title_fullStr | Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title_short | Safety of Immunosuppressive Drugs Used as Maintenance Therapy in Kidney Transplantation: A Systematic Review and Meta-Analysis |
title_sort | safety of immunosuppressive drugs used as maintenance therapy in kidney transplantation: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817604/ https://www.ncbi.nlm.nih.gov/pubmed/24275847 http://dx.doi.org/10.3390/ph6101170 |
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