Cyclosporine formulation and Kaposi's sarcoma after renal transplantation

Dario Cattaneo, Eliana Gotti, Norberto Perico, Guido Bertolini, Gad Kainer, Giuseppe Remuzzi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in transplant patients receiving Neoral or Sandimmune as a part of their immunosuppressive therapy. Methods. In all, 668 kidney transplant recipient followed at our Nephrology Unit from 1970 to 2003 entered this retrospective analysis; 300 were on CsA Sandimmune-based and 308 on CsA Neoral-based therapy. The primary endpoint was the occurrence of KS. Results. KS was diagnosed in 20 out of 608 patients given CsA with an incidence rate of 4.7 per 1000 patients per year. No episodes of KS was found in the preCsA era. Among patients on CsA, those treated with Neoral had fourfold higher incidence rate of KS than in the Sandimmune group (10.7 vs. 2.3 per 1000 patients per year). Kaplan-Meier analysis shows that patients on Neoral had lower cumulative KS-free probability than those on Sandimmune. Cox's analysis documented that Neoral was a positive predictor of KS development as compared to Sandimmune (hazard ratio: 2.237). Among patients on Neoral, those who developed KS had higher daily exposure to the drug assessed by pharmacokinetic studies. Conclusions. In recipients of kidney transplant CsA Neoral increases the risk of KS as compared to the Sandimmune formulation, possibly due to enhanced drug bioavailability and ultimately patients daily CsA exposure.

Original languageEnglish
Pages (from-to)743-748
Number of pages6
JournalTransplantation
Volume80
Issue number6
DOIs
Publication statusPublished - Sep 27 2005

Fingerprint

Kaposi's Sarcoma
Kidney Transplantation
Cyclosporine
Incidence
Kidney
Nephrology
Kaplan-Meier Estimate
Immunosuppressive Agents
Pharmaceutical Preparations
Immunosuppression
Biological Availability

Keywords

  • Cyclosporine
  • Kaposi's sarcoma
  • Kidney transplantation
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Cyclosporine formulation and Kaposi's sarcoma after renal transplantation. / Cattaneo, Dario; Gotti, Eliana; Perico, Norberto; Bertolini, Guido; Kainer, Gad; Remuzzi, Giuseppe.

In: Transplantation, Vol. 80, No. 6, 27.09.2005, p. 743-748.

Research output: Contribution to journalArticle

@article{35c7e7cc6aac4ea4bdd1b6e6e61b0497,
title = "Cyclosporine formulation and Kaposi's sarcoma after renal transplantation",
abstract = "Background. Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in transplant patients receiving Neoral or Sandimmune as a part of their immunosuppressive therapy. Methods. In all, 668 kidney transplant recipient followed at our Nephrology Unit from 1970 to 2003 entered this retrospective analysis; 300 were on CsA Sandimmune-based and 308 on CsA Neoral-based therapy. The primary endpoint was the occurrence of KS. Results. KS was diagnosed in 20 out of 608 patients given CsA with an incidence rate of 4.7 per 1000 patients per year. No episodes of KS was found in the preCsA era. Among patients on CsA, those treated with Neoral had fourfold higher incidence rate of KS than in the Sandimmune group (10.7 vs. 2.3 per 1000 patients per year). Kaplan-Meier analysis shows that patients on Neoral had lower cumulative KS-free probability than those on Sandimmune. Cox's analysis documented that Neoral was a positive predictor of KS development as compared to Sandimmune (hazard ratio: 2.237). Among patients on Neoral, those who developed KS had higher daily exposure to the drug assessed by pharmacokinetic studies. Conclusions. In recipients of kidney transplant CsA Neoral increases the risk of KS as compared to the Sandimmune formulation, possibly due to enhanced drug bioavailability and ultimately patients daily CsA exposure.",
keywords = "Cyclosporine, Kaposi's sarcoma, Kidney transplantation, Therapeutic drug monitoring",
author = "Dario Cattaneo and Eliana Gotti and Norberto Perico and Guido Bertolini and Gad Kainer and Giuseppe Remuzzi",
year = "2005",
month = "9",
day = "27",
doi = "10.1097/01.tp.0000173803.97398.31",
language = "English",
volume = "80",
pages = "743--748",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Cyclosporine formulation and Kaposi's sarcoma after renal transplantation

AU - Cattaneo, Dario

AU - Gotti, Eliana

AU - Perico, Norberto

AU - Bertolini, Guido

AU - Kainer, Gad

AU - Remuzzi, Giuseppe

PY - 2005/9/27

Y1 - 2005/9/27

N2 - Background. Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in transplant patients receiving Neoral or Sandimmune as a part of their immunosuppressive therapy. Methods. In all, 668 kidney transplant recipient followed at our Nephrology Unit from 1970 to 2003 entered this retrospective analysis; 300 were on CsA Sandimmune-based and 308 on CsA Neoral-based therapy. The primary endpoint was the occurrence of KS. Results. KS was diagnosed in 20 out of 608 patients given CsA with an incidence rate of 4.7 per 1000 patients per year. No episodes of KS was found in the preCsA era. Among patients on CsA, those treated with Neoral had fourfold higher incidence rate of KS than in the Sandimmune group (10.7 vs. 2.3 per 1000 patients per year). Kaplan-Meier analysis shows that patients on Neoral had lower cumulative KS-free probability than those on Sandimmune. Cox's analysis documented that Neoral was a positive predictor of KS development as compared to Sandimmune (hazard ratio: 2.237). Among patients on Neoral, those who developed KS had higher daily exposure to the drug assessed by pharmacokinetic studies. Conclusions. In recipients of kidney transplant CsA Neoral increases the risk of KS as compared to the Sandimmune formulation, possibly due to enhanced drug bioavailability and ultimately patients daily CsA exposure.

AB - Background. Transplantation enhances the risk of malignancies, due to the chronic use of antirejection medication. In the case of Kaposi's sarcoma (KS) the permissive effect of immunosuppression has been extensively studied, and cyclosporine (CsA) appears to play a key role. Here we have compared the incidence of KS in transplant patients receiving Neoral or Sandimmune as a part of their immunosuppressive therapy. Methods. In all, 668 kidney transplant recipient followed at our Nephrology Unit from 1970 to 2003 entered this retrospective analysis; 300 were on CsA Sandimmune-based and 308 on CsA Neoral-based therapy. The primary endpoint was the occurrence of KS. Results. KS was diagnosed in 20 out of 608 patients given CsA with an incidence rate of 4.7 per 1000 patients per year. No episodes of KS was found in the preCsA era. Among patients on CsA, those treated with Neoral had fourfold higher incidence rate of KS than in the Sandimmune group (10.7 vs. 2.3 per 1000 patients per year). Kaplan-Meier analysis shows that patients on Neoral had lower cumulative KS-free probability than those on Sandimmune. Cox's analysis documented that Neoral was a positive predictor of KS development as compared to Sandimmune (hazard ratio: 2.237). Among patients on Neoral, those who developed KS had higher daily exposure to the drug assessed by pharmacokinetic studies. Conclusions. In recipients of kidney transplant CsA Neoral increases the risk of KS as compared to the Sandimmune formulation, possibly due to enhanced drug bioavailability and ultimately patients daily CsA exposure.

KW - Cyclosporine

KW - Kaposi's sarcoma

KW - Kidney transplantation

KW - Therapeutic drug monitoring

UR - http://www.scopus.com/inward/record.url?scp=26644467460&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=26644467460&partnerID=8YFLogxK

U2 - 10.1097/01.tp.0000173803.97398.31

DO - 10.1097/01.tp.0000173803.97398.31

M3 - Article

C2 - 16210960

AN - SCOPUS:26644467460

VL - 80

SP - 743

EP - 748

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 6

ER -