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Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis

Background: Tacrolimus (TAC) is used for the management of ulcerative colitis (UC). However, there are few reports on the effectiveness of its long-term administration. TAC is also known to cause renal toxicity. The aim of this study was to evaluate long-term effectiveness and monitor changes in ren...

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Autores principales: Haga, Keiichi, Shibuya, Tomoyoshi, Nomura, Kei, Okahara, Koki, Nomura, Osamu, Ishikawa, Dai, Sakamoto, Naoto, Osada, Taro, Nagahara, Akihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355962/
https://www.ncbi.nlm.nih.gov/pubmed/32517388
http://dx.doi.org/10.3390/jcm9061771
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author Haga, Keiichi
Shibuya, Tomoyoshi
Nomura, Kei
Okahara, Koki
Nomura, Osamu
Ishikawa, Dai
Sakamoto, Naoto
Osada, Taro
Nagahara, Akihito
author_facet Haga, Keiichi
Shibuya, Tomoyoshi
Nomura, Kei
Okahara, Koki
Nomura, Osamu
Ishikawa, Dai
Sakamoto, Naoto
Osada, Taro
Nagahara, Akihito
author_sort Haga, Keiichi
collection PubMed
description Background: Tacrolimus (TAC) is used for the management of ulcerative colitis (UC). However, there are few reports on the effectiveness of its long-term administration. TAC is also known to cause renal toxicity. The aim of this study was to evaluate long-term effectiveness and monitor changes in renal function during prolonged TAC use in patients with UC. Methods: Medical records of 50 UC patients treated with TAC were retrospectively reviewed. Clinical outcomes were assessed at 6, 12, 24, and 36 months after initiating TAC. We also monitored chronological changes in renal function. Results: Thirty-nine patients were treated with TAC for more than 3 months. Relapse-free survival among these patients at 6, 12, 24, and 36 months was 82%, 69%, 41%, and 23%, respectively. On the other hand, renal function was reduced in 35.9% of patients. We found that irreversible renal dysfunction was more likely to occur in cases in which the estimated glomerular-filtration rate (eGFR) was reduced by more than 30%. Conclusion: This study demonstrated the potential use of TAC as an effective option in the long-term medical management of UC, although it tended to increase the risk of nephrotoxicity. There is a need for the careful monitoring of renal function during TAC administration.
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spelling pubmed-73559622020-07-22 Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis Haga, Keiichi Shibuya, Tomoyoshi Nomura, Kei Okahara, Koki Nomura, Osamu Ishikawa, Dai Sakamoto, Naoto Osada, Taro Nagahara, Akihito J Clin Med Article Background: Tacrolimus (TAC) is used for the management of ulcerative colitis (UC). However, there are few reports on the effectiveness of its long-term administration. TAC is also known to cause renal toxicity. The aim of this study was to evaluate long-term effectiveness and monitor changes in renal function during prolonged TAC use in patients with UC. Methods: Medical records of 50 UC patients treated with TAC were retrospectively reviewed. Clinical outcomes were assessed at 6, 12, 24, and 36 months after initiating TAC. We also monitored chronological changes in renal function. Results: Thirty-nine patients were treated with TAC for more than 3 months. Relapse-free survival among these patients at 6, 12, 24, and 36 months was 82%, 69%, 41%, and 23%, respectively. On the other hand, renal function was reduced in 35.9% of patients. We found that irreversible renal dysfunction was more likely to occur in cases in which the estimated glomerular-filtration rate (eGFR) was reduced by more than 30%. Conclusion: This study demonstrated the potential use of TAC as an effective option in the long-term medical management of UC, although it tended to increase the risk of nephrotoxicity. There is a need for the careful monitoring of renal function during TAC administration. MDPI 2020-06-07 /pmc/articles/PMC7355962/ /pubmed/32517388 http://dx.doi.org/10.3390/jcm9061771 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Haga, Keiichi
Shibuya, Tomoyoshi
Nomura, Kei
Okahara, Koki
Nomura, Osamu
Ishikawa, Dai
Sakamoto, Naoto
Osada, Taro
Nagahara, Akihito
Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title_full Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title_fullStr Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title_full_unstemmed Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title_short Effectiveness and Nephrotoxicity of Long-Term Tacrolimus Administration in Patients with Ulcerative Colitis
title_sort effectiveness and nephrotoxicity of long-term tacrolimus administration in patients with ulcerative colitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355962/
https://www.ncbi.nlm.nih.gov/pubmed/32517388
http://dx.doi.org/10.3390/jcm9061771
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