 |
 |
 |
 |
 |
 |
 |
|
|
|
|||||||||
|
|||||||||||
Research Articles |
OBJECTIVE: To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and economic issues associated with sirolimus, the most recent immunosuppressive agent approved for kidney transplantation. DATA SOURCES: A MEDLINE search (1966-June 2000) was completed to identify primary and review articles. In addition, abstracts from recent meetings on transplantation were reviewed for information and research on sirolimus. STUDY SELECTION AND DATA EXTRACTION: Blinded, randomized, controlled studies were the goal, but, as with most newly approved immunosuppressive agents, a significant amount of information on sirolimus is not available in this optimal form. All articles were assessed and all pertinent information was incorporated in this review. DATA SYNTHESIS: Sirolimus is structurally related to the immunosuppressive agent tacrolimus, and retains a pharmacokinetic and drug interaction profile similar to that of the calcineurin inhibitors, cyclosporine and tacrolimus. However, the novel mechanism of action of sirolimus differs significantly from these agents, as does its adverse effect profile. The most significant adverse reaction is hyperlipidemia. Clinical experience with sirolimus has allowed transplant centers to expand its use into other areas of transplantation as well as certain autoimmune disorders. CONCLUSIONS: The definitive role of sirolimus will continue to be determined; however, sirolimus offers an excellent addition to the transplant immunosuppression armamentarium.
This article has been cited by other articles:
|
|
 |
|
  M. D. Duncan and D. S. Wilkes Transplant-related Immunosuppression: A Review of Immunosuppression and Pulmonary Infections Proceedings of the ATS, December 1, 2005; 2(5): 449 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Boffa, F. Luan, D. Thomas, H. Yang, V. K. Sharma, M. Lagman, and M. Suthanthiran Rapamycin Inhibits the Growth and Metastatic Progression of Non-Small Cell Lung Cancer Clin. Cancer Res., January 1, 2004; 10(1): 293 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. Smith, L. E. Wrenshall, R. F. Nicosia, R. Pichler, C. L. Marsh, C. E. Alpers, N. Polissar, and C. L. Davis Delayed Graft Function and Cast Nephropathy Associated with Tacrolimus Plus Rapamycin Use J. Am. Soc. Nephrol., April 1, 2003; 14(4): 1037 - 1045. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Grolleau, J. Bowman, B. Pradet-Balade, E. Puravs, S. Hanash, J. A. Garcia-Sanz, and L. Beretta Global and Specific Translational Control by Rapamycin in T Cells Uncovered by Microarrays and Proteomics J. Biol. Chem., June 14, 2002; 277(25): 22175 - 22184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Cruz, A. L. Goldstein, J. Blankenship, M. Del Poeta, J. R. Perfect, J. H. McCusker, Y. L. Bennani, M. E. Cardenas, and J. Heitman Rapamycin and Less Immunosuppressive Analogs Are Toxic to Candida albicans and Cryptococcus neoformans via FKBP12-Dependent Inhibition of TOR Antimicrob. Agents Chemother., November 1, 2001; 45(11): 3162 - 3170. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Huffman, I. Mothe-Satney, and J. C. Lawrence Jr. Insulin-stimulated phosphorylation of lipin mediated by the mammalian target of rapamycin PNAS, January 22, 2002; 99(2): 1047 - 1052. [Abstract] [Full Text] [PDF]
|
|
 |
 |
 |
 |
 |
 |
 |
