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New Formulations of Tacrolimus and Prevention of Acute and Chronic Rejections in Adult Kidney-Transplant Recipients

New Formulations of Tacrolimus and Prevention of Acute and Chronic Rejections in Adult Kidney-Transplant Recipients

Thomas Jouve, Lionel Rostaing, Paolo Malvezzi

Expert Opin Drug Saf. 2017 Jul;16(7):845-855.

PMID: 28494654

Abstract:

Introduction: As tolerance is not yet achievable, the kidney-transplanted-patients have to take on a daily-basis immunosuppressive drugs in order to avoid acute rejection-AR-. The cornerstone of immunosuppression relies on tacrolimus-therapy which is potentially nephrotoxic. Areas Covered: We identified from the studies published in the recent years those who were reporting on AR in de novo kidney-transplant recipients under tacrolimus-based therapy, as well as those who reported on the attempt to minimize tacrolimus-therapy.
Results:
There are many formulations of tacrolimus: immediate-release (Prograf®), slow-release (Advagraf®), or extended-release (Envarsus®). All demonstrate a very good efficacy in preventing AR episodes. Studies in which tacrolimus was minimized or even weaned-off have shown that it was unsafe, i.e. in resulting in AR episode and/or de novo donor-specific alloantibodies. Recent data show that Tacrobell®, a generic of tacrolimus, was as efficient as Prograf® in the short- and long-term. Expert-opinion: Tacrolimus-based immunosuppression is very effective in preventing rejection in kidney-transplant recipients. It might be associated with nephrotoxicity, that can be reduced by avoiding tacrolimus trough levels too high in the long-term. Conversely, tacrolimus ultraminimization should not be attempted.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP109581933-A	Tacrolimus		109581-93-3	Price

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