Evaluating the conversion to extended-release tacrolimus from immediate-release tacrolimus in liver transplant recipients

David Choi*, Sarang Thaker, Patricia West-Thielke, Annesti Elmasri, Christine Chan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background A new formulation of once daily extended-release tacrolimus (LCP-tac, Envarsus XR) was approved for use in the USA for kidney transplant recipients in 2015. There are limited data regarding real-world observations with conversion to LCP-tac in liver transplant recipients. Methods We performed a retrospective analysis of liver transplant recipients treated with LCP-tac. Data collection included (1) reasons for switching to LCP-tac; (2) conversion ratio used; (3) kidney function at time of conversion and 3 months after; (4) outcomes of conversion [acute cellular rejection rates and cytomegalovirus (CMV) viremia] within 3 months of conversion. Results Average conversion ratio used to achieve therapeutic drug level without further dose adjustment was 1:0.73 (SD 0.11). Median time after transplant was 508 days (IQR 736). Common reasons patients were switched to LCP-tac were from fluctuations in tacrolimus levels (44%) and adverse effect of tremor (32%). Among patients who were switched due to tremors 88% noted significant improvement. There was no difference in serum creatinine (P = 0.55) or glomerular filtration rate (P = 0.64) from baseline to 3 months postconversion. There were no episodes of acute cellular rejections or CMV viremia postconversion. Conclusion This observational study demonstrated that conversion of immediate-release tacrolimus to LCP-tac in liver transplant recipients was well tolerated and effective.

Original languageEnglish (US)
Pages (from-to)1124-1128
Number of pages5
JournalEuropean Journal of Gastroenterology and Hepatology
Volume33
Issue number8
DOIs
StatePublished - Aug 1 2021

Keywords

  • envarsus
  • immunosuppression
  • LCP-tacrolimus
  • liver transplant

ASJC Scopus subject areas

  • General Medicine

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