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?

• Main Authors: Paolo Carta, Federica Curci, Leonardo Caroti, Larti Aida, Lorenzo Di Maria, Lino Cirami
• Format: Article
• Language: English
• Published: Codon Publications 2020-05-01
• Series: Journal of Renal and Hepatic Disorders
• Subjects: kidney transplantation; extended-dose-release Tacrolimus; melt-dose Tacrolimus; renal function; tremors; high metabolizer recipients
• Online Access: https://jrenhep.com/index.php/jrenhep/article/view/68

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 monocentric 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.