Body weight alterations under early corticosteroid withdrawal and chronic corticosteroid therapy with modern immunosuppression

• Published in: Transplantation Vol. 80; no. 1; p. 26
• Main Authors: Rogers, Christin C, Alloway, Rita R, Buell, Joseph F, Boardman, Robyn, Alexander, J Wesley, Cardi, Michael, Roy-Chaudhury, Prabir, First, M Roy, Succop, Paul, Munda, Rino, Woodle, E Steve
• Format: Journal Article
• Language: English
• Published: United States 15.07.2005
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Body Mass Index; Body Weight - drug effects; Drug Administration Schedule; Drug Therapy, Combination; Follow-Up Studies; Graft Rejection - drug therapy; Graft Rejection - microbiology; Histocompatibility Testing; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Mycophenolic Acid - administration & dosage; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Sirolimus - administration & dosage; Sirolimus - therapeutic use; Time Factors; Weight Gain - drug effects
• ISSN: 0041-1337
• DOI: 10.1097/01.TP.0000164290.17030.BC

Weight gain is a known complication of corticosteroid maintenance therapy. The purpose of the present study was to compare patterns of weight gain under chronic corticosteroid therapy (CCST) with that observed under early (i.e., within 7 days posttransplant) corticosteroid withdrawal (CSWD) in renal-transplant recipients. Renal-transplant recipients who underwent early CSWD under four prospective, institutional review board-approved clinical trials were compared with a historic control group of patients receiving maintenance CCST. One hundred sixty-nine patients with early CSWD were compared with 132 patients who received CCST. Mean population weight gain was significantly higher in CCST patients at 3, 6, and 12 months posttransplant. Race influenced weight gain because white CSWD patients demonstrated greater reductions in weight gain compared with African-American patients. Sex also influenced weight gain: women demonstrated a greater benefit from CSWD than did men. Corticosteroid rejection therapy in CSWD patients completely restored weight gain because these patients showed weight gains similar to the CCST group. Finally, pretransplant body mass index (BMI) also influenced weight gain because patients who were overweight (BMI 25-30) or obese (BMI>30) demonstrated a greater reduction in weight gain with CSWD than did patients of normal weight (BMI<25). Early CSWD minimizes weight gain in renal-transplant recipients. Women, whites, and patients with high pretransplant BMI had greater reductions in weight gain with early CSWD.