Clinical recommendations for the use of everolimus in heart transplantation
Abstract Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute rejection in adult heart transplant recipients. Proliferation signal inhibitors have a mechanism of action with both immunosuppressive and ant...
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| Published in | Transplantation reviews (Philadelphia, Pa.) Vol. 24; no. 3; pp. 129 - 142 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.07.2010
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| Online Access | Get full text |
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| Abstract | Abstract Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute rejection in adult heart transplant recipients. Proliferation signal inhibitors have a mechanism of action with both immunosuppressive and antiproliferative effects, representing an especially interesting treatment option for the prevention and management of some specific conditions in heart transplant population, such as graft vasculopathy or malignancies. Proliferation signal inhibitors have been observed to work synergistically with calcineurin inhibitors (CNIs). Data from clinical trials and from the growing clinical experience show that when administered concomitantly with CNIs, PSIs allow significant dose reductions of the latter without loss of efficacy, a fact that has been associated with stabilization or significant improvement in renal function in patients with CNI-induced nephrotoxicity. The purpose of this article was to review the current knowledge of the role of PSIs in heart transplantation to provide recommendations for the proper use of EVL in cardiac transplant recipients, including indications, treatment regimens, monitoring, and management of the adverse events. |
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| AbstractList | Abstract Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute rejection in adult heart transplant recipients. Proliferation signal inhibitors have a mechanism of action with both immunosuppressive and antiproliferative effects, representing an especially interesting treatment option for the prevention and management of some specific conditions in heart transplant population, such as graft vasculopathy or malignancies. Proliferation signal inhibitors have been observed to work synergistically with calcineurin inhibitors (CNIs). Data from clinical trials and from the growing clinical experience show that when administered concomitantly with CNIs, PSIs allow significant dose reductions of the latter without loss of efficacy, a fact that has been associated with stabilization or significant improvement in renal function in patients with CNI-induced nephrotoxicity. The purpose of this article was to review the current knowledge of the role of PSIs in heart transplantation to provide recommendations for the proper use of EVL in cardiac transplant recipients, including indications, treatment regimens, monitoring, and management of the adverse events. Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute rejection in adult heart transplant recipients. Proliferation signal inhibitors have a mechanism of action with both immunosuppressive and antiproliferative effects, representing an especially interesting treatment option for the prevention and management of some specific conditions in heart transplant population, such as graft vasculopathy or malignancies. Proliferation signal inhibitors have been observed to work synergistically with calcineurin inhibitors (CNIs). Data from clinical trials and from the growing clinical experience show that when administered concomitantly with CNIs, PSIs allow significant dose reductions of the latter without loss of efficacy, a fact that has been associated with stabilization or significant improvement in renal function in patients with CNI-induced nephrotoxicity. The purpose of this article was to review the current knowledge of the role of PSIs in heart transplantation to provide recommendations for the proper use of EVL in cardiac transplant recipients, including indications, treatment regimens, monitoring, and management of the adverse events. |
| Author | Díaz, Beatriz González-Vílchez, Francisco Mirabet, Sònia Palomo, Jesús Delgado, Juan F Almenar, Luis Arizón, José M Manito, Nicolás Crespo-Leiro, Maria G Fernández-Yáñez, Juan Segovia, Javier Rodríguez Lambert, José L Roig, Eulàlia |
| Author_xml | – sequence: 1 fullname: Manito, Nicolás – sequence: 2 fullname: Delgado, Juan F – sequence: 3 fullname: Crespo-Leiro, Maria G – sequence: 4 fullname: González-Vílchez, Francisco – sequence: 5 fullname: Almenar, Luis – sequence: 6 fullname: Arizón, José M – sequence: 7 fullname: Díaz, Beatriz – sequence: 8 fullname: Fernández-Yáñez, Juan – sequence: 9 fullname: Mirabet, Sònia – sequence: 10 fullname: Palomo, Jesús – sequence: 11 fullname: Rodríguez Lambert, José L – sequence: 12 fullname: Roig, Eulàlia – sequence: 13 fullname: Segovia, Javier |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20619801$$D View this record in MEDLINE/PubMed |
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| Snippet | Abstract Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute... Proliferation signal inhibitors (PSIs), everolimus (EVL), and sirolimus are a group of immunosuppressor agents indicated for the prevention of acute rejection... |
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| SubjectTerms | Everolimus Heart Transplantation Humans Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use Sirolimus - adverse effects Sirolimus - analogs & derivatives Sirolimus - therapeutic use Surgery |
| Title | Clinical recommendations for the use of everolimus in heart transplantation |
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