Publication
Title
Prospective randomized study of conversion from tacrolimus to cyclosporine A to improve glucose metabolism in patients with posttransplant diabetes mellitus after renal transplantation
Author
Abstract
Tacrolimus (TAC) increases the risk of posttransplant diabetes (PTDM) compared with cyclosporine A (CYC). The present 12-month, multicenter, investigator-driven, prospective, randomized study was designed to assess whether conversion from tacrolimus to CYC can reverse PTDM after renal transplantation. Predominantly white patients with PTDM according to the 2005 American Diabetes Association criteria were randomized to either replacement of TAC with CYC or continuation of their TAC-based regimen after stratification for type of glucose-lowering therapy, steroid therapy, and hepatitis C status. At 12months, 14 of 41 patients with complete data in the CYC arm (34%; 95%CI 19%-49%) were free of diabetes, whereas this was the case in only 4 of 39 patients (10%; 95%CI 3%-20%) in the TAC arm (P=.01). At 12months, 39% of patients in the CYC arm were off glucose-lowering medication vs 13% of patients in the TAC arm (P=.01). The CYC group decreased glycated hemoglobin level during the 12-month follow-up, resulting in significantly lower levels compared with the TAC group (6.00.9% vs 7.1 +/- 1.7% at 12months; P=.002). In conclusion, replacement of TAC with CYC significantly improves glucose metabolism and has the potential to reverse diabetes during the first year after conversion. (EU Clinical Trials Register No. 2006-001765-42) This randomized, controlled trial demonstrates a reversal of posttransplant diabetes in 34% of patients at 12 months following replacement of tacrolimus with cyclosporine A.
Language
English
Source (journal)
American journal of transplantation. - Copenhagen
Publication
Copenhagen : 2018
ISSN
1600-6135
Volume/pages
18 :7 (2018) , p. 1726-1734
ISI
000437727800019
Pubmed ID
29337426
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 02.08.2018
Last edited 20.09.2021
To cite this reference