Newer immunosuppressive drugs : A review

• Published in: Journal of the American Society of Nephrology Vol. 10; no. 6; pp. 1366 - 1380
• Main Authors: GUMMERT, J. F, IKONEN, T, MORRIS, R. E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.06.1999
• Subjects: Animals; Biological and medical sciences; Clinical Trials as Topic; Humans; Immunomodulators; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Isoxazoles - pharmacology; Isoxazoles - therapeutic use; Leflunomide; Medical sciences; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - pharmacology; Mycophenolic Acid - therapeutic use; Pharmacology. Drug treatments; Sirolimus - pharmacology; Sirolimus - therapeutic use; Tacrolimus - pharmacology; Tacrolimus - therapeutic use; Human; Mofetil; Drug; Mycophenolic acid; Toxicity; Receiver; Monoclonal antibody; Leflunomide; Discounting; Chemotherapy; Specificity; Immunology; Interleukin 2; Tacrolimus; Secondary effect; Immunosuppressive agent; Pharmacokinetics
• ISSN: 1046-6673; 1533-3450
• DOI: 10.1681/ASN.V1061366

In recent years, many new immunosuppressive drugs have been discovered and developed for clinical use in transplantation. This review focuses on those drugs (leflunomide, mycophenolate mofetil, sirolimus, tacrolimus) that have been shown to have immunosuppressive activity in patients. Different anti-interleukin-2 receptor antibodies are also reviewed as an example of a resurgence of development in the area of monoclonal antibodies. The price for reducing the incidence of allograft rejection by improved immunosuppression was thought to be a proportional increase in the incidence of infection and malignancy. Data from Phase III clinical trials of new immunosuppressants, however, show a statistically significant reduction in the incidence of acute rejection produced by these new drugs, which has not been accompanied by increases in infection and malignancy rates. The wide array of new drugs offers the opportunity to use combinations that block different pathways of immune activation while at the same time selecting drug combinations with nonoverlapping toxicity profiles so that doses of each single drug can be reduced below toxicity levels. The immunosuppressive therapy for patients can be tailored according to their individual needs.