Evidence map›Paper›PMID 30993185›Full record

ArticleTransplantation direct2019

Safety and Efficacy of Reduced Prolonged-release Tacrolimus Exposure in De Novo Kidney Transplantation: A Randomized, Open-label, Pilot Study in Asia-OPTIMIZE Study.

Young Hoon Kim, Yang-Jen Chiang, Sung-Joo Kim, Myoung Soo Kim, Sung Bae Park, Sheng-Tang Wu, Kazuhiro Horita, Yoshihiro Nakashima, Hongsi Jiang, Duck-Jong Han

Open access · goldAbstract read
In one paragraph

Article in Transplantation direct, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 3 countries.

Young Hoon KimDivision of Kidney and Pancreas Transplant, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Yang-Jen ChiangDivision of Urology, Department of Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan City, Taiwan.
Sung-Joo KimDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Myoung Soo KimDepartment of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sung Bae ParkDepartment of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea.
Sheng-Tang WuDivision of Urology, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei City, Taiwan.
Kazuhiro HoritaAstellas Pharma, Inc., Tokyo, Japan.
Yoshihiro NakashimaAstellas Pharma, Inc., Tokyo, Japan.
Hongsi JiangAstellas Pharma, Inc., MAAO, Singapore.
Duck-Jong HanDivision of Kidney and Pancreas Transplant, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Astellas Pharma (Japan) · JPChang Gung University · TWKeimyung University Dongsan Medical Center · KRSungkyunkwan University · KRTri-Service General Hospital · TWYonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA multicenter, randomized, open-label, parallel group, pilot, 52-week study in Asian countries that assessed the renal function, efficacy, and safety of reduced-exposure versus standard-exposure prolonged-release tacrolimus (PR-T) in adult kidney transplant recipients (KTRs).

methodsPosttransplantation, KTRs received PR-T from weeks 0 to 4 (initial dose, 0.2-0.3 mg/kg; target trough level, 6-10 ng/mL). At week 4, KTRs were randomized (1:1) to receive reduced-exposure PR-T (target 4-6 ng/mL, weeks 4-12; 3-5 ng/mL, weeks 12-52) or standard-exposure PR-T (target: 6-10 ng/mL, weeks 4-52). Primary end point: estimated glomerular filtration rate (eGFR) over 52 weeks. Secondary end points (week 52) included creatinine clearance, serum creatinine, graft/patient survival, biopsy-confirmed acute rejection (AR), composite of graft loss/patient death/biopsy-confirmed AR, and steroid-resistant AR. Treatment-emergent adverse events were recorded.

resultsSixty-six KTRs received PR-T (reduced-exposure, n = 32; standard-exposure, n = 34) and were analyzed. After per-protocol dose adjustment, mean ± standard deviation tacrolimus trough level was lower with reduced- versus standard-exposure PR-T (week 52, 4.5 ± 1.1 ng/mL vs 8.0 ± 2.2 ng/mL). In the reduced- versus standard-exposure group, eGFR was similar at weeks 8 to 52 (overall least-square mean difference, -2.82; 95% confidence interval, -7.91 to 2.27;

conclusionsReducing exposure to PR-T resulted in a clinically acceptable short-term safety profile and was generally as effective as standard tacrolimus exposure for Asian patients.

Identifiers

PMID30993185
PMCPMC6445651
OpenAlexW2930681503

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.