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1: J Am Soc Nephrol. 2008 Jul;19(7):1411-8. Epub 2008 Apr 2.Click here to read Click here to read Links
Comment in:
J Am Soc Nephrol. 2008 Jul;19(7):1255-6.

Sirolimus is associated with new-onset diabetes in kidney transplant recipients.

Johnston O, Rose CL, Webster AC, Gill JS.

Division of Nephrology, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC, Canada.

New-onset diabetes (NOD) is associated with transplant failure. A few single-center studies have suggested that sirolimus is associated with NOD, but this is not well established. With the use of data from the United States Renal Data System, this study evaluated the association between sirolimus use at the time of transplantation and NOD among 20,124 adult recipients of a first kidney transplant without diabetes. Compared with patients treated with cyclosporine and either mycophenolate mofetil orazathioprine, sirolimus-treated patients were at increased risk for NOD, whether it was used in combination with cyclosporine (adjusted hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.36 to 1.90),tacrolimus (adjusted HR 1.66; 95% CI 1.42 to 1.93), or an antimetabolite (mycophenolate mofetil orazathioprine; adjusted HR 1.36; 95% CI 1.09 to 1.69). Similar results were obtained in a subgroup analysis that included the 16,861 patients who did not have their immunosuppressive regimen changed throughout the first posttransplantation year. In conclusion, sirolimus is independently associated with NOD.Given the negative impact of NOD on posttransplantation outcomes, these findings should be confirmed in prospective studies or in meta-analyses of existing trials that involved sirolimus.

PMID: 18385422 [PubMed - indexed for MEDLINE]

PMCID: PMC2440303

Patient Drug Information

  • Cyclosporine (Neoral® , Sandimmune® , Gengraf® )

    Cyclosporine and cyclosporine (modified) are used with other medications to prevent transplant rejection (attack of the transplanted organ by the immune system of the person who received the organ) in people who have rec...

  • Tacrolimus (Prograf® )

    Tacrolimus is used along with other medications to prevent rejection (attack of a transplanted organ by the immune system of a person receiving the organ) in people who have received kidney, liver, or heart transplants. ...

  • Sirolimus (Rapamune® )

    Sirolimus is used in combination with other medications to prevent rejection of kidney transplants. Sirolimus is in a class of medications called immunosuppressants. It works by suppressing the body's immune system.

  • » See all 4 drug reports ...
  • Source: AHFS Consumer Medication Information