Abstract
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▴ Tacrolimus is a calcineurin inhibitor recently approved in the US and throughout the EU for the prevention of allograft rejection in heart transplant recipients. It is commonly administered orally for long-term immunosuppression.
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▴ The incidence of mild to severe acute rejection in the first 6 months following heart transplantation was significantly lower in tacrolimus recipients than in ciclosporin recipients (54% vs 66%) in a large, phase III trial conducted in Europe.
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▴ A large, phase III trial conducted in the US did not show a significant difference between tacrolimus and ciclosporin in the incidence of severe rejection or haemodynamic compromise rejection requiring treatment within the first 6 months post-transplant (22% vs 32%), but did show a significant difference in the incidence at 1 year (23% vs 37%).
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▴ In phase III trials, 1-year patient survival was similar between tacrolimus and ciclosporin recipients in the EU (93% vs 92%) and the US (95% vs 90%).
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▴ Tacrolimus was shown to be effective in the prevention of rejection in paediatric and African American heart transplant recipients.
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▴ The tolerability profile of tacrolimus in heart transplant recipients was broadly similar to that of ciclosporin, although tacrolimus was usually associated with lower incidences of post-transplant hypertension and dyslipidaemia.
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McCormack, P.L., Keating, G.M. Tacrolimus. Drugs 66, 2269–2279 (2006). https://doi.org/10.2165/00003495-200666170-00010
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DOI: https://doi.org/10.2165/00003495-200666170-00010