Management of Side Effects of Sirolimus Therapy
- 27 April 2009
- journal article
- research article
- Published by Wolters Kluwer Health in Transplantation
- Vol. 87 (8S) , S23-S26
Abstract
Sirolimus (SRL) has been shown to improve long-term graft survival in several calcineurin inhibitor avoidance/minimization protocols. Although SRL has been suggested to reduce the progression of chronic renal graft damage and to prevent the development of neoplasia, two of the most prominent challenges in the field of transplantation, its use is significantly limited by an extremely high incidence of side effects. Some of the side effects are directly linked to the antiproliferative action of SRL, whereas the mechanisms underlying most of the undesired effects of the drug are still far from being clarified. Nevertheless, there is an increasing body of evidence linking most these drug-associated events to SRL dose. In addition, it is now possible to identify well-defined risk factors for most of these effects. Thus, to limit SRL-related side effects the two golden rules are (1) accurate selection of patients to be treated and (2) avoidance of high SRL doses.Keywords
This publication has 29 references indexed in Scilit:
- Mammalian Target of Rapamycin Inhibitor Dyslipidemia in Kidney Transplant RecipientsAmerican Journal of Transplantation, 2008
- Sirolimus Is Associated with New-Onset Diabetes in Kidney Transplant RecipientsJournal of the American Society of Nephrology, 2008
- Incidence of anemia in sirolimus-treated renal transplant recipients: the importance of preserving renal functionTransplant International, 2007
- Sirolimus Interferes with Iron Homeostasis in Renal Transplant RecipientsTransplantation, 2006
- Glucose Metabolism in Renal Transplant RecipientsJournal of the American Society of Nephrology, 2005
- Sirolimus for Kaposi's Sarcoma in Renal-Transplant RecipientsNew England Journal of Medicine, 2005
- Effects of Sirolimus on Lipids in Renal Allograft Recipients: An Analysis Using the Framingham Risk ModelAmerican Journal of Transplantation, 2002
- Exposure-response relationships for everolimus in de novo kidney transplantation: defining a therapeutic rangeTransplantation, 2002
- Opposite Translational Control of GLUT1 and GLUT4 Glucose Transporter mRNAs in Response to InsulinJournal of Biological Chemistry, 1999
- Rapamune® (RAPA, rapamycin, sirolimus): mechanism of action immunosuppressive effect results from blockade of signal transduction and inhibition of cell cycle progressionClinical Biochemistry, 1998