Saudi Journal of Kidney Diseases and Transplantation

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 29  |  Issue : 6  |  Page : 1267--1273

Comparative analysis for optimizing the modified release tacrolimus (Advagraf) after kidney transplantation: A prospective randomized trial


Mohamed Adel Bakr, Ayman Maher Nagib, Ahmed Farouk Donia, Ahmed Abdelfattah Denewar, Mohamed Megahid Abu-Elmagd, Mohamed Hamed Abbas, Ahmed Mansour Abdel-Rahman, Mohamed Elsayed Mashaly, Mohamed Mohamed Elsaftawy, Mohamed Ahmed Ghoneim 
 Department of Dialysis and Transplantation, The Urology -Nephrology Center, Mansoura University, Mansoura, Egypt

Correspondence Address:
Prof. Mohamed Adel Bakr
Department of Dialysis and Transplantation, The Urology -Nephrology Center, Mansoura University, Mansoura
Egypt

Immunosuppression management in clinical transplantation aims to balance delivery of efficacy against adverse reactions using therapeutic drug monitoring. Adherence to posttransplant immunosuppressive medications and minimizing variability in drug exposure are important considerations in preventing rejection and maximizing overall transplant outcomes. The availability of once-daily tacrolimus may add a potential benefit by simplifying immunosuppressive regimens, though improving compliance among transplant recipients. The aim of our study is to investigate the safety and efficacy of the once-daily formulation of tacrolimus (Advagraf) against the usually used twice daily tablets (Prograf). A prospective randomized trial 1:2 was designed for 99 consecutive live-related renal transplant recipients who received their grafts at a single center (study group, Advagraf, 33 recipients and control group, Prograf, 66 recipients). The demographic data were homogeneous among both groups regarding donors and patients’ characteristics. Posttransplant hypertension, infection, malignancy, and diabetes mellitus were comparable among both groups. Renal function and rejection episodes showed no statistical significance among recipients of both groups. Despite slight higher Advagraf unit doses, there was no statistical difference regarding the tacrolimus trough levels, between the two groups. Our singlecenter experience revealed that the availability of once-daily tacrolimus formulation could give potential benefit of improved medication compliance and better allograft outcomes by decreasing pill burden and thereby simplifying dosing schedule, Advagraf was non-inferior to twice-daily tacrolimus regarding safety and efficacy. Although being nonsignificant, a trend for better kidney function was noted in this short-term study in the Advagraf group, so long-term follow-up is needed to verify this.


How to cite this article:
Bakr MA, Nagib AM, Donia AF, Denewar AA, Abu-Elmagd MM, Abbas MH, Abdel-Rahman AM, Mashaly ME, Elsaftawy MM, Ghoneim MA. Comparative analysis for optimizing the modified release tacrolimus (Advagraf) after kidney transplantation: A prospective randomized trial.Saudi J Kidney Dis Transpl 2018;29:1267-1273


How to cite this URL:
Bakr MA, Nagib AM, Donia AF, Denewar AA, Abu-Elmagd MM, Abbas MH, Abdel-Rahman AM, Mashaly ME, Elsaftawy MM, Ghoneim MA. Comparative analysis for optimizing the modified release tacrolimus (Advagraf) after kidney transplantation: A prospective randomized trial. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2019 Jun 16 ];29:1267-1273
Available from: http://www.sjkdt.org/article.asp?issn=1319-2442;year=2018;volume=29;issue=6;spage=1267;epage=1273;aulast=Bakr;type=0