Conversion from Extended-Dose-Release Tacrolimus to Melt-Dose Tacrolimus in High Metabolizer Patients Is the New Formulation of LPCT the Best Option for High Metabolizer Kidney Transplanted Patients?

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Paolo Carta
Federica Curci
Leonardo Caroti
Aida Larti
Lorenzo Dimaria
Lino Cirami


kidney transplantation; extended-dose-release Tacrolimus; melt-dose Tacrolimus; renal function; tremors; high metabolizer recipients



Tacrolimus (FK506) is the most widely used anti-rejection drug in kidney transplantation, especially its extended release Tacrolimus formulation (ER-Tac, Advagraf), which is used when target blood levels can be difficult to reach in high metabolizer patients. In this retrospective monocen-tric study, we analyzed the effect of a switch from ER-Tac to LifeCycle Pharma Tacrolimus (LPCT, Envarsus) on the dose/level ratio of FK506 in high metabolizer patients that cannot achieve target blood levels in the first 6 months after transplantation.
We observed a statistically significant improvement in the level to dose ratio after the switch. Renal function remained stable. We also observed a reduction in the development of tremors.

Our data suggest that LPCT can be used in a safer way in high metabolizer kidney transplant recipients.


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