Effectiveness of maintenance immunosuppression therapies in a matched-pair analysis cohort of 16 years of renal transplant in the brazilian national health system

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dc.creatorRosângela Maria Gomes
dc.creatorWallace Breno Barbosa
dc.creatorBrian Godman
dc.creatorJuliana de Oliveira Costa
dc.creatorNélio Gomes Ribeiro Junior
dc.creatorCharles Simão Filho
dc.creatorMariângela Leal Cherchiglia
dc.creatorFrancisco de Assis Acurcio
dc.creatorAugusto Afonso Guerra Júnior
dc.date.accessioned2023-08-03T23:08:22Z
dc.date.accessioned2025-09-09T00:35:22Z
dc.date.available2023-08-03T23:08:22Z
dc.date.issued2020-03-17
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.3390/ijerph17061974
dc.identifier.issn1660-4601
dc.identifier.urihttps://hdl.handle.net/1843/57448
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofInternational Journal of Environmental Research and Public Health
dc.rightsAcesso Aberto
dc.subjectTransplante renal
dc.subjectImunossupressores
dc.subjectSobrevivência de Enxerto
dc.subjectAvaliação de Eficácia-Efetividade de Intervenções
dc.subjectTacrolimo
dc.subjectCiclosporina
dc.subjectEpidemiologia Clínica
dc.subject.otherreal-world data
dc.subject.otherRenal transplantation
dc.subject.otherImmunosuppressants
dc.subject.otherGraft survival
dc.subject.otherEffectiveness
dc.subject.otherTacrolimus
dc.subject.otherCyclosporine
dc.subject.otherClinical epidemiology
dc.titleEffectiveness of maintenance immunosuppression therapies in a matched-pair analysis cohort of 16 years of renal transplant in the brazilian national health system
dc.typeArtigo de periódico
local.citation.epage15
local.citation.issue6
local.citation.spage1
local.citation.volume17
local.description.resumoThe maintenance of patients with renal transplant typically involves two or more drugs to prevent rejection and prolong graft survival. The calcineurin inhibitors (CNI) are the most commonly recommended medicines in combinations with others. While immunosuppressive treatment regimens are well established, there is insufficient long-term effectiveness data to help guide future management decisions. The study analyzes the effectiveness of treatment regimens containing CNI after renal transplantation during 16 years of follow-up with real-world data from the Brazilian National Health System (SUS). This was a retrospective study of 2318 SUS patients after renal transplantion. Patients were propensity score-matched (1:1) by sex, age, type and year of transplantation. Kaplan–Meier analysis was used to estimate the cumulative probabilities of survival. A Cox proportional hazard model was used to evaluate factors associated with progression to graft loss. Multivariable analysis, adjusted for diabetes mellitus and race/color, showed a greater risk of graft loss for patients using tacrolimus plus mycophenolate compared to patients treated with cyclosporine plus azathioprine. In conclusion, this Brazilian real-world study, with a long follow-up period using matched analysis for relevant clinical features and the representativeness of the sample, demonstrated improved long-term effectiveness for therapeutic regimens containing cyclosporine plus azathioprine. Consequently, we recommend that protocols and clinical guidelines for renal transplantation should consider the cyclosporine plus azathioprine regimen as a potential first line option, along with others.
local.identifier.orcid0000-0003-4119-8925
local.publisher.countryBrasil
local.publisher.departmentFAR - DEPARTAMENTO DE FARMÁCIA SOCIAL
local.publisher.departmentMED - DEPARTAMENTO DE CIRURGIA
local.publisher.departmentMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL
local.publisher.initialsUFMG
local.url.externahttps://www.mdpi.com/1660-4601/17/6/1974

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