Real-World Administration of Once-Daily MeltDose^® Prolonged-Release Tacrolimus (LCPT) Allows for Dose Reduction of Tacrolimus and Stabilizes Graft Function Following Liver Transplantation

• Main Authors: Katharina Willuweit, Alexandra Frey, Anne Hörster, Fuat Saner, Kerstin Herzer
• Format: Article
• Language: English
• Published: MDPI AG 2021-12-01
• Series: Journal of Clinical Medicine
• Subjects: liver transplantation; MeltDose®; once-daily prolonged-release tacrolimus; LCPT; switch; efficacy
• Online Access: https://www.mdpi.com/2077-0383/10/1/124

The calcineurin inhibitor tacrolimus is included in most immunosuppressive protocols after liver transplantation. This retrospective, observational 24-month study investigated the tolerability of once-daily MeltDose^® prolonged-release tacrolimus (LCPT) after switching from twice-daily immediate-release tacrolimus (IR-Tac) in a real-world cohort of 150 patients with previous liver transplantation. No graft rejection or new safety signals were observed. Only 7.3% of patients discontinued LCPT due to side effects. In the overall patient population, median liver transaminases, total cholesterol, triglycerides, glucose, and HbA_1c remained constant after switching to LCPT. Total cholesterol significantly decreased (<i>p</i> ≤ 0.002) in patients with initially elevated levels (>200 mg/dL). A total of 71.8% of 96 patients maintained a glomerular filtration rate >60 mL/min/1.73 m² throughout the study, while 44.7% of patients were classified as fast metabolizers and 55.3% as slow metabolizers. Median daily tacrolimus dose could be reduced by 50% in fast metabolizers and by 30% in slow metabolizers, while trough levels were maintained in the target range (4–6 ng/mL). In conclusion, our observational study confirmed previous evidence of good overall tolerability and a favorable outcome for the patients after switching from IR-Tac to LCPT after liver transplantation.