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Claesson, Kerstin
Publications (4 of 4) Show all publications
Campistol, J. M., Eris, J., Oberbauer, R., Friend, P., Hutchison, B., Morales, J., . . . Neylan, J. F. (2006). Sirolimus therapy after early cyclosporine withdrawal reduces the risk for cancer in adult renal transplantation. Journal of the American Society of Nephrology, 17(2), 581-589
Open this publication in new window or tab >>Sirolimus therapy after early cyclosporine withdrawal reduces the risk for cancer in adult renal transplantation
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2006 (English)In: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 17, no 2, p. 581-589Article in journal (Refereed) Published
Abstract [en]

Sirolimus (SRL) is a mammalian target of rapamycin inhibitor that, in contrast to cyclosporine (CsA), has been shown to inhibit rather than promote cancers in experimental models. At 3 mo +/- 2 wk after renal transplantation, 430 of 525 enrolled patients were randomly assigned to remain on SRL-CsA-steroids (ST) or to have CsA withdrawn and SRL troughs increased two-fold (SRL-ST). Median times to first skin and nonskin malignancies were compared between treatments using a survival analysis. Mean annualized rates of skin malignancy were calculated, and the relative risk was determined using a Poisson model. Malignancy-free survival rates for nonskin malignancies were compared using Kaplan-Meier estimates and the log-rank test. At 5 yr, the median time to a first skin carcinoma was delayed (491 versus 1126 d; log-rank test, P = 0.007), and the risk for an event was significantly lower with SRL-ST therapy (relative risk SRL-ST to SRL-CsA-ST 0.346; 95% confidence interval 0.227 to 0.526; P < 0.001, intention-to-treat analysis). The relative risks for both basal and squamous cell carcinomas were significantly reduced. Kaplan-Meier estimates of nonskin cancer were 9.6 versus 4.0% (SRL-CsA-ST versus SRL-ST; P = 0.032, intention-to-treat analysis). Nonskin cancers included those of the lung, larynx, oropharynx, kidney, gastrointestinal tract, prostate, breast, thyroid, and cervix as well as glioma, liposarcoma, astrocytoma, leukemia, lymphoma, and Kaposi's sarcoma. Patients who received SRL-based, calcineurin inhibitor-free therapy after CsA withdrawal at month 3 had a reduced incidence of both skin and nonskin malignancies at 5 yr after renal transplantation compared with those who received SRL therapy combined with CsA. Longer follow-up and additional trials are needed to confirm these promising results.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-10957 (URN)10.1681/ASN.2005090993 (DOI)000242120200034 ()16434506 (PubMedID)
Available from: 2007-05-07 Created: 2007-05-07 Last updated: 2017-12-11Bibliographically approved
Bottiger, Y., Brattström, C., Bäckman, L., Claesson, K. & Burke, J. (2005). Trimethoprim-sulphamethoxazole does not affect the pharmacokinetics of sirolimus in renal transplant recipients.. Br J Clin Pharmacol, 60, 566-569
Open this publication in new window or tab >>Trimethoprim-sulphamethoxazole does not affect the pharmacokinetics of sirolimus in renal transplant recipients.
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2005 (English)In: Br J Clin Pharmacol, Vol. 60, p. 566-569Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-75502 (URN)
Available from: 2006-02-09 Created: 2006-02-09 Last updated: 2011-01-11
Vitko, S., Klinger, M., Salmela, K., Wlodarczyk, Z., Tydèn, G., Senatorski, G., . . . Kramer, B. K. (2005). Two corticosteroid-free regimens-tacrolimus monotherapy after basiliximab administration and tacrolimus/mycophenolate mofetil-in comparison with a standard triple regimen in renal transplantation: results of the Atlas study.. Transplantation, 80(12), 1734-41
Open this publication in new window or tab >>Two corticosteroid-free regimens-tacrolimus monotherapy after basiliximab administration and tacrolimus/mycophenolate mofetil-in comparison with a standard triple regimen in renal transplantation: results of the Atlas study.
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2005 (English)In: Transplantation, ISSN 0041-1337, Vol. 80, no 12, p. 1734-41Article in journal (Refereed) Published
Keywords
Adrenal Cortex Hormones, Adult, Aged, Antibodies; Monoclonal/*therapeutic use, Drug Administration Schedule, Drug Therapy; Combination, Humans, Immunosuppressive Agents/therapeutic use, Kidney Failure; Chronic/surgery, Kidney Transplantation/*immunology/mortality, Middle Aged, Mycophenolic Acid/analogs & derivatives/therapeutic use, Recombinant Fusion Proteins/*therapeutic use, Survival Analysis, Tacrolimus/*administration & dosage/*therapeutic use, Treatment Failure, Treatment Outcome
Identifiers
urn:nbn:se:uu:diva-10958 (URN)16378069 (PubMedID)
Available from: 2007-05-07 Created: 2007-05-07 Last updated: 2011-01-12
Mota, A., Arias, M., Claesson, K. & Neylan, J. (2004). Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years. Am J Transplant, 4, 953-961
Open this publication in new window or tab >>Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
2004 (English)In: Am J Transplant, Vol. 4, p. 953-961Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-72699 (URN)
Available from: 2005-05-27 Created: 2005-05-27 Last updated: 2011-01-12
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