Efficacy and safety of extended-release versus standard-release tacrolimus in kidney transplantation: A meta-analysis / 中华器官移植杂志

ABSTRACT

Objective To assess the efficacy and safety of extended-release versus standardrelease in kidney transplant recipients.Methods We searched Pubmed,Embase,Medline and Cochrane library databases in English and researched published randomized controlled trials (RCTs)focused on extended-release versus standard-release tacrolimus in renal transplant recipients until March 2016.The risk of bias assessment for RCTs was evaluated using the Cochrane Collaboration's tool,and quality of RCTs was assessed by the modified JADAD scale.Meta-analysis was conducted by Review Manager 5.3 and Stata SE 12.0.Results A total of 12 RCTs were included,involving 3 532 adult kidney transplant recipients.There was no significant difference between the two treatment groups in the endpoints such as acute rejection rate (RR =0.93[0.78 1.11],P =0.40),graft survival (RR=1.04[0.79-1.37],P =0.76),patient survival (RR =1.03[0.67-1.57],P =0.90),patients withdrawn (RR =1.07[0.95-1.22],P =0.26),estimated glomemlar filtration rate (eGFR) (MD =-0.52[-1.95,0.92],P =0.48),creatinine clearance (Ccr) (MD =-0.94 [-1.39,3.28],P =0.43),infection (RR=0.98[0.90-1.06],P =0.57),and new-onset diabetes rate (RR =0.91[0.67-1.23],P =0.53).Meanwhile,subgroup analysis of different patient population (early after transplantation vs.late after transplantation) showed similar results in the protocol.Conclusion The extended-release tacrolimus has similar efficacy and safety to the standard-release in kidney transplantation.