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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 1998 June;50(2):161-4

language: English

Advantages of ­Neoral con­ver­sion in re­nal trans­plant pa­tients

Vennarecci G. 1, Pisani F. 1, Tisone G. 1, Buonomo O. 1, Famulari A. 2, Casciani C. U. 1

1 Department of Surgery, University of Tor Vergata, Rome, Italy;
2 Department of Surgical Disciplines, University of L’Aquila, L’Aquila, Italy


Background. Sandimmun Neoral is a mi­cro­emul­sion for­mu­la­tion of Sandimmun cy­clo­spor­in (Cya) ­with pre­dict­able phar­ma­cok­i­net­ics, super­i­or ab­sorp­tion and ­less de­pen­dent ­upon ­bile pro­duc­tion. Recently Neoral re­placed the old Cya in the clin­i­cal ­ground.
Methods. The aim of ­this ­study was to as­sess the ef­fec­tive­ness, safe­ty and ad­van­tag­es of ­this con­ver­sion in 90 ­adult re­nal trans­plant pa­tients ­with ­stable re­nal func­tion trans­plant­ed at ­least 24 ­months ear­li­er. There ­were 48 ­males and 42 fe­males ­with a ­mean age of 39 ­years (­range: 18-56). Mean inter­val ­from trans­plant to con­ver­sion was 3.6 ­years (­range: 2.7-5.4). Conversion ­rate was 1:1. Mean Neoral ­dose at con­ver­sion was 3.8 mg/kg/day (range: 2.1-5.7).
Results. One ­month af­ter con­ver­sion ­mean Neoral ­dose was 3.4 mg/kg/day (­range: 2.2- 3.9) and at six ­months was 3.2 mg/kg/day (range: 2.1-4). Serum crea­ti­nine and CyA ­trough lev­els re­mained ­stable. We did not ob­serve re­jec­tion epi­sodes or in­fec­tions. The in­ci­dence of ­side ef­fects due to CyA was slight­ly in­creased and ­there ­were not dif­fer­enc­es in ­terms of ar­te­ri­al pres­sure val­ues and num­ber of anti­hy­per­ten­sive ­drugs giv­en.
Conclusions. The con­clu­sion is ­drown ­that con­ver­sion to Neoral is ­safe and re­sults in rap­id at­tain­ment of ther­a­peu­tic ­trough lev­els. Six ­months af­ter con­ver­sion the ­mean Neoral ­dose was de­creased of 0.6 mg/kg/die per pa­tient.

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