Everolimus and Long-term Clinical Outcomes in Kidney Transplant Recipients: A Registry-based 10-year Follow-up of 5 Randomized Trials

Tracey Ying, Germaine Wong, Wai H. Lim, Philip Clayton, John Kanellis, Helen Pilmore, Scott Campbell, Philip J. O'Connell, Graeme Russ, Steven Chadban

Research output: Contribution to journalArticle

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Abstract

Background. Data regarding the long-term efficacy of everolimus-based immunosuppression for kidney transplantation are lacking. Existing randomized controlled trials are limited by short follow-up duration which limits capacity to assess impact on graft and patient survival. Methods. We linked individual trial participants to the Australian and New Zealand Dialysis and Transplant Registry. Using a 1-step meta-analysis approach, we investigated the 10-year risk of graft loss, mortality and graft function in 349 participants from 5 randomized trials of everolimus-based immunosuppression. Results. Two hundred forty-two patients randomized to everolimus and 107 control patients were followed for a median of 9 years (interquartile range, 7.1, 9.8 y). There were no significant differences in the risk of all-cause graft loss (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.69-1.94), mortality (adjusted HR, 1.51; 95% CI, 0.78-2.93) and death-censored graft loss in everolimus versus control (adjusted HR, 1.00; 95% CI, 0.50-2.01). For patients in the early initiation (de novo or

Original languageEnglish
Pages (from-to)1705-1713
Number of pages9
JournalTransplantation
Volume103
Issue number8
DOIs
Publication statusPublished - Aug 2019

Cite this

Ying, Tracey ; Wong, Germaine ; Lim, Wai H. ; Clayton, Philip ; Kanellis, John ; Pilmore, Helen ; Campbell, Scott ; O'Connell, Philip J. ; Russ, Graeme ; Chadban, Steven. / Everolimus and Long-term Clinical Outcomes in Kidney Transplant Recipients : A Registry-based 10-year Follow-up of 5 Randomized Trials. In: Transplantation. 2019 ; Vol. 103, No. 8. pp. 1705-1713.
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abstract = "Background. Data regarding the long-term efficacy of everolimus-based immunosuppression for kidney transplantation are lacking. Existing randomized controlled trials are limited by short follow-up duration which limits capacity to assess impact on graft and patient survival. Methods. We linked individual trial participants to the Australian and New Zealand Dialysis and Transplant Registry. Using a 1-step meta-analysis approach, we investigated the 10-year risk of graft loss, mortality and graft function in 349 participants from 5 randomized trials of everolimus-based immunosuppression. Results. Two hundred forty-two patients randomized to everolimus and 107 control patients were followed for a median of 9 years (interquartile range, 7.1, 9.8 y). There were no significant differences in the risk of all-cause graft loss (adjusted hazard ratio [HR], 1.16; 95{\%} confidence interval [CI], 0.69-1.94), mortality (adjusted HR, 1.51; 95{\%} CI, 0.78-2.93) and death-censored graft loss in everolimus versus control (adjusted HR, 1.00; 95{\%} CI, 0.50-2.01). For patients in the early initiation (de novo or",
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Ying, T, Wong, G, Lim, WH, Clayton, P, Kanellis, J, Pilmore, H, Campbell, S, O'Connell, PJ, Russ, G & Chadban, S 2019, 'Everolimus and Long-term Clinical Outcomes in Kidney Transplant Recipients: A Registry-based 10-year Follow-up of 5 Randomized Trials' Transplantation, vol. 103, no. 8, pp. 1705-1713. https://doi.org/10.1097/TP.0000000000002499

Everolimus and Long-term Clinical Outcomes in Kidney Transplant Recipients : A Registry-based 10-year Follow-up of 5 Randomized Trials. / Ying, Tracey; Wong, Germaine; Lim, Wai H.; Clayton, Philip; Kanellis, John; Pilmore, Helen; Campbell, Scott; O'Connell, Philip J.; Russ, Graeme; Chadban, Steven.

In: Transplantation, Vol. 103, No. 8, 08.2019, p. 1705-1713.

Research output: Contribution to journalArticle

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AU - Ying, Tracey

AU - Wong, Germaine

AU - Lim, Wai H.

AU - Clayton, Philip

AU - Kanellis, John

AU - Pilmore, Helen

AU - Campbell, Scott

AU - O'Connell, Philip J.

AU - Russ, Graeme

AU - Chadban, Steven

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N2 - Background. Data regarding the long-term efficacy of everolimus-based immunosuppression for kidney transplantation are lacking. Existing randomized controlled trials are limited by short follow-up duration which limits capacity to assess impact on graft and patient survival. Methods. We linked individual trial participants to the Australian and New Zealand Dialysis and Transplant Registry. Using a 1-step meta-analysis approach, we investigated the 10-year risk of graft loss, mortality and graft function in 349 participants from 5 randomized trials of everolimus-based immunosuppression. Results. Two hundred forty-two patients randomized to everolimus and 107 control patients were followed for a median of 9 years (interquartile range, 7.1, 9.8 y). There were no significant differences in the risk of all-cause graft loss (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.69-1.94), mortality (adjusted HR, 1.51; 95% CI, 0.78-2.93) and death-censored graft loss in everolimus versus control (adjusted HR, 1.00; 95% CI, 0.50-2.01). For patients in the early initiation (de novo or

AB - Background. Data regarding the long-term efficacy of everolimus-based immunosuppression for kidney transplantation are lacking. Existing randomized controlled trials are limited by short follow-up duration which limits capacity to assess impact on graft and patient survival. Methods. We linked individual trial participants to the Australian and New Zealand Dialysis and Transplant Registry. Using a 1-step meta-analysis approach, we investigated the 10-year risk of graft loss, mortality and graft function in 349 participants from 5 randomized trials of everolimus-based immunosuppression. Results. Two hundred forty-two patients randomized to everolimus and 107 control patients were followed for a median of 9 years (interquartile range, 7.1, 9.8 y). There were no significant differences in the risk of all-cause graft loss (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.69-1.94), mortality (adjusted HR, 1.51; 95% CI, 0.78-2.93) and death-censored graft loss in everolimus versus control (adjusted HR, 1.00; 95% CI, 0.50-2.01). For patients in the early initiation (de novo or

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KW - IMMUNOSUPPRESSION

KW - REJECTION

KW - SIROLIMUS

KW - THERAPY

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