Tacrolimus hyperlipidemia with

Tacrolimus has shown the propensity to cause less severe hyperlipidemia when compared with cyclosporine. Thus conversion from cyclosporine-based immunosuppression to tacrolimus-based immunosuppression may be one way to counteract this disease in transplant recipients.66 Studies demonstrate that steroid withdrawal in renal transplant patients lowered total cholesterol by 17% and LDL-C by 16% unfortunately, an 18% decrease in high-density lipoprotein (HDL) levels also was noted in these patients.66... 

Hypertriglyceridemia due to sirolimus often does not respond to dosage reduction or hypolipidemic drugs. After liver transplantation (n — 6), significant hyperlipidemia improved after withdrawal of sirolimus (1070). The incidence of sirolimus-associated hyperlipidemia is up to 44%. After liver transplantation, there was hypercholesterolemia in 15% and hypertriglyceridemia in 10% of recipients. Sirolimus in combination with tacrolimus... 

Taylor DO, Barr ML, Radovancevic B, Renlund DG, Mentzer RM, Jr., Smart FW,Tolman DE, Frazier OFI, Young JB,VanVeldhuisen P. A randomized, multicenter comparison of tacrolimus and cyclosporine immunosuppressive regimens in cardiac transplantation decreased hyperlipidemia and hypertension with tacrolimus. J Fleart Lung Transplant 1999 18 336-345. 

P. A randomized, multicenter comparison of tacrolimus and cyclosporine immunosuppressive regimens in cardiac transplantation decreased hyperlipidemia and hypertension with tacrolimus. J Heart Lung Transplant 1999 18 336-345. 

A multicenter randomized comparative trial of tacrolimus in combination with azathioprine or mycofenolate mofetU (MMF) versus cyclosporin (microemulsion) with MMF after cadaveric kidney transplantation demonstrated that all regimens yielded similar acute rejection and graft survival rates at 1 year. The tacrolimus-MMF regimen was associated with the lowest rate of steroid-resistant rejection requiring antilymphocyte therapy. In addition, the tacrolimus-treated patients had lower incidence of hyperlipidemia, a side effect of particular concern in these patients [60]. 

Ciclosporin versus tacrolimus In a retrospective comparison of ciclosporin and tacrolimus in 100 liver transplant recipients who were followed for 12 months, the incidences of new-onset arterial hypertension and diabetes mellitus were not different [6 ]. However, there was a significantly higher incidence of hyperlipidemia in those who took ciclosporin, with a greater difference at 6 months than at 12 months. 

Systematic reviews In a systematic review of 10 randomized trials in 952 heart transplant recipients, a ciclosporin-based immunosuppressive regimen caused more hypertension, hyperlipidemia, gingival hyperplasia, and hirsutism than tacrolimus [7 ]. There were no significant differences with regard to acute rejection, diabetes mellitus, renal dysfunction, infection, malignancy, or neurotoxicity. 

---