A meta-analysis of therapeutic effect of cyclosporine microemulsion and tacrolimus for patients undergoing liver transplantation
10.3724/SP.J.1008.2008.00663
- Author:
Liang XIAO
1
Author Information
1. Department of Liver Transplantation
- Publication Type:Journal Article
- Keywords:
Cyclosporine microemulsion;
Liver transplantation;
Meta-analysis;
Tacrolimus
- From:
Academic Journal of Second Military Medical University
2010;29(6):663-670
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the efficacy and safety of microemulsified cyclosporine (Neoral) and tacrolimus (FK506) for immunodepression after liver transplantation. Methods: According to the including criteria, fifteen randomized controlled trials were enrolled in this analysis. The data of trial design, characteristics of the subjects, and findings of the studies were reviewed and analyzed by RevMan 4. 2. 8 software. Results: The patient survival rate, graft survival rate, incidence of nephrotoxicity, and incidence of infection were not significantly different between Neoral and FK506 groups, with the relative risk and (95% CI, P) being 0.99(0.96-1.02, 0.37), 0.97 (0.92-1.03, 0.30), 0.99 (0.87-1.13, 0.86) and 1.08(0.97-1.20, 0.16), respectively. The incidences of hypertension (1.34[1.15-1.55, 0.0001]) and acute rejection (1.15[1.06-1.25, 0.001]) were significantly lower in the FKS06 group, with no significant difference found in the degree of acute rejection (1.00[0.92-1.22], 0.98). Interestingly, the incidence of diabetes was significantly higher in the FKS06 group within 1 year after the operation, but was similar to that of the Neoral group thereafter, with relative risk(95%CI, P)being 0.72(0.62-0.83, < 0.0001) and 1.47 (0.98-2.20, 0.06), respectively. Conclusion: The 2 drugs have comparable patient/graft survival rates and incidences of nephrotoxicity and infection. FKS06 can better reduce the incidence of acute rejection, but can not alleviate the degree of rejection. FK506 should be recommended for patients suffering from hypertension after liver transplantation and Neoral should be recommended for patients with diabetes.
