ISHLT 31st Annual Meeting and Scientific Sessions
SAN DIEGO – Following heart transplantation, everolimus-based
immunosuppression and a reduction of cyclosporine dose was
safe and improved renal function compared with conventional treatment in more
than 200 patients. Further, researchers found that it may also reduce the
incidence of lymphomas.
Researchers of the prospective, randomized trial randomly assigned
patients (n=213, >18 years of age) stratified by age, gender,
creatinine and presence of coronary artery disease into one
of two groups: cyclosporine reduction plus everolimus-based (EVL)
immunosuppression (n=108) or conventional treatment (n=105). They defined
improvement in renal function as an increase greater than 5 ml/min.
What they found was that renal function improved in EVL patients (37.4%
vs. 13.9%; P<.001). Also reported was an increase in creatinine the
conventional arm (P<.01) whereas no statistically significant
increase was found in the EVL arm.
Additionally, at 3 years Modification of Diet in Renal Disease (MDRD)
lowered in conventionally treated patients (P<.01), while a modest
improvement was found in the EVL group. Similarly, benefits in lymphoma
incidence were also reported in the EVL group, as no one had a lymphoma vs. six
in the conventional group (P=.04).
These findings led Roberto Fiocchi, MD, PhD, with the Heart
Transplantation Center, Ospedali Riuniti di Bergamo, Bergamo, Italy, and study
investigator, to conclude in his presentation that this practice is feasible.
However, “You have to know that there is a significantly higher incidence
rate of one infection [in the EVL group],” he said. “These
observations raise the question can we improve survival? We don’t know
yet.” – by Brian Ellis
Disclosure: Dr. Fiocchi serves on the speakers’ bureau for
For more information:
- Fiocchi R. Featured Abstract #1. Presented at: ISHLT 31st Annual
Meeting and Scientific Sessions; April 13-16, 2011; San Diego.