Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors (2023)

Iwulicz, S., Pawel, E., Kirkpatrick, C., Dooley, M.i Snell, G. (2023).Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors.Transplant International,36, [10704].https://doi.org/10.3389/ti.2023.10704

Ivulich, Steven; Paul, Eldo ; Kirkpatrick, Carlme inside. /Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors. W:Transplant International. 2023; Bd. 36.

@article{bee26ec7290a4e61a05e6bc257c65641,

title = "Everolimus-Based Immunosuppressive Strategies in Adult Lung Transplant Patients: Minimization of Calcineurin Inhibitors Versus Elimination of Calcineurin Inhibitors",

abstract = “Everolimus (EVE) offers an alternative to maintenance immunosuppression when conventional immunosuppression cannot be tolerated. EVE can be used with a strategy to minimize or eliminate calcineurin inhibitors (CRFs). To date, clinical studies of EVE after lung transplantation (LTx) have mainly focused on minimization strategies to preserve renal function. The main objective was to determine the preferred method of using EVE in lung transplant recipients (LTR). To achieve this goal, we compared the safety and efficacy results of EVE in minimizing and eliminating immunosuppressive therapies. Single-center retrospective study of 217 LTRs initiated after EVE (120 CRF minimization and 97 CRF elimination). Survival scores were calculated from the start date of EVE. In a multivariate analysis, LTRs receiving EVE as part of the CRF elimination strategy had poorer survival compared to the CRF minimization strategy [HR 1.61, 95% CI: 1.11-2.32, p=0.010]. The use of EVE for renal preservation was associated with improved survival compared to other indications [HR 0.64, 95% CI: 0.42-0.97, p=0.032]. EVE can be successfully used to maintain immunosuppression after LTx, especially to protect the kidneys. However, immunosuppressive therapies with low doses of CKD resulted in better survival outcomes, highlighting the importance of preserving CKD where possible."

keywords="calcineurin inhibitor, everolimus, lung transplant recipient, lung transplant survival, lung transplant, rapamycin inhibitor target in mammals, nephrotoxicity",

Auteur = "Steven Ivulich i Eldho Paul i Carl Kirkpatrick i Michael Dooley i Greg Snell",

note = "Editor's copyright: Copyright {\textcopyright} 2023 Ivulich, Paul, Kirkpatrick, Dooley, and Snell.",

year = "2023",

month = January,

tag = "20",

twee = "10.3389/ti.2023.10704",

language="English",

content = "36",

Magazine = "Transplant International",

issn = „0934-0874”,

Publisher = "Frontiers Media SA",

}

Iwulicz, S, Pawel, E, Kirkpatrick, C, Dooley, M& Fast, G 2023, „Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors',Transplant International, geb. 36, 10704.https://doi.org/10.3389/ti.2023.10704

Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors./ Ivulich, Steven; Paul, Eldo; Kirkpatrick, Carlme inside.

W:Transplant International, geb. 36, 10704, 20.01.2023.

test result:journal entry›Article›To test›Judgement

YOU - TAG

T1 - Everolimus-based immunosuppressive strategies in adult lung transplant patients

T2 - Minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors

AU - Ivulich, Steven

AU – Paul, Eldho

AU – Kirkpatrick, Carl

AU - Dooley, Michael

ME – Snell, Greg

N1 - Publisher Copyright: Copyright © 2023 Ivulich, Paul, Kirkpatrick, Dooley and Snell.

GJ – 20.01.2023

Year 1 – 20.01.2023

N2 - Everolimus (EVE) is an alternative to maintenance immunosuppression when conventional immunosuppression cannot be tolerated. EVE can be used with a strategy to minimize or eliminate calcineurin inhibitors (CRFs). To date, clinical studies of EVE after lung transplantation (LTx) have mainly focused on minimization strategies to preserve renal function. The main objective was to determine the preferred method of using EVE in lung transplant recipients (LTR). To achieve this goal, we compared the safety and efficacy results of EVE with immunosuppressive drug minimization and elimination regimens. Single-center retrospective study of 217 LTRs initiated EVE (120 CRF minimization and 97 CRF elimination). Survival scores were calculated from the start date of EVE. In a multivariate analysis, LTRs receiving EVE as part of the CRF elimination strategy had poorer survival compared to the CRF minimization strategy [HR 1.61, 95% CI: 1.11-2.32, p=0.010]. The use of EVE for renal preservation was associated with improved survival compared to other indications [HR 0.64, 95% CI: 0.42-0.97, p=0.032]. EVE can be successfully used to maintain immunosuppression after LTx, especially to protect the kidneys. However, low-dose CKD immunosuppressive therapies yielded better survival outcomes, highlighting the importance of preserving CKD whenever possible.

AB - Everolimus (EVE) is an alternative to maintenance immunosuppression when conventional immunosuppression cannot be tolerated. EVE can be used with a strategy to minimize or eliminate calcineurin inhibitors (CRFs). To date, clinical studies of EVE after lung transplantation (LTx) have mainly focused on minimization strategies to preserve renal function. The main objective was to determine the preferred method of using EVE in lung transplant recipients (LTR). To achieve this goal, we compared the safety and efficacy results of EVE with immunosuppressive drug minimization and elimination regimens. Single-center retrospective study of 217 LTRs initiated EVE (120 CRF minimization and 97 CRF elimination). Survival scores were calculated from the start date of EVE. In a multivariate analysis, LTRs receiving EVE as part of the CRF elimination strategy had poorer survival compared to the CRF minimization strategy [HR 1.61, 95% CI: 1.11-2.32, p=0.010]. The use of EVE for renal preservation was associated with improved survival compared to other indications [HR 0.64, 95% CI: 0.42-0.97, p=0.032]. EVE can be successfully used to maintain immunosuppression after LTx, especially to protect the kidneys. However, low-dose CKD immunosuppressive therapies yielded better survival outcomes, highlighting the importance of preserving CKD whenever possible.

KW - Calcineurin Inhibitor

KW - Everolimus

KW - recipient of a lung transplant

KW - Lung Transplant Survival

KW - lung transplant

KW - Mammal target of rapamycin inhibitor

KW - Nephrotoxicity

UR – http://www.scopus.com/inward/record.url?scp=85147340642&partnerID=8YFLogxK

U2 - 10.3389/ti.2023.10704

DO – 10.3389/ti.2023.10704

M3 - artillery

C2 - 36744051

AN-SCOPUS:85147340642

VL - 36

JO – Transplantation International

JF - Transplantation International

SN-0934-0874

M1 - 10704

IS -

Iwulicz S, Paul E, Kirkpatrick C, Dooley M, Quick G.Everolimus-based immunosuppressive strategies in adult lung transplant patients: minimization of calcineurin inhibitors versus elimination of calcineurin inhibitors.Transplant International. January 2023 20:36. 10704.https://doi.org/10.3389/ti.2023.10704