New-onset diabetes mellitus in cyclosporine-treated organ transplant patients in Taiwan: Interim analysis (6 months) of postmarketing surveillance

Y. F. Tian, C. S. Tsai, P. C. Lee, S. H. Chu, Y. S. Chien, C. C. Loong, C. H. Chen, M. S. Wu, S. H. Chu, J. D. Lian

Research output: Contribution to journalArticle

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Abstract

Posttransplant new-onset diabetes mellitus (NODM) is an important complication among patients receiving immunosuppressants. It has a considerable impact on chronic allograft dysfunction. Calcineurin inhibitors have been implicated in the development of posttransplant NODM. Since high-risk candidates also undergo transplantation, prevention and control of posttransplant NODM is important. A 3-year postmarketing surveillance study is currently underway in Taiwan to evaluate the incidence and risk factors leading to development of NODM among de novo and maintenance solid-organ transplant patients receiving cyclosporine (CsA)-based immunosuppressive therapy. Concomitant therapy consisted of basiliximab, mycophenolate mofetil or enteric-coated mycophenolate sodium, and corticosteroids. Diabetes was diagnosed according to the American Diabetes Association criteria. This 6-month protocol-defined interim analysis included 101 patients (84 de novo, 17 maintenance) who received renal (n = 77), liver (n = 13), or heart (n = 11) transplantation. At the end of 6 months, 8/101 (7.92%) patients experienced NODM. The mean time to NODM was 3.05 months. No significant difference was observed between NODM and non-NODM patients for risk factors: age, body mass index, blood pressure, gender, high-density lipoproteins/triglycerides hdl/tg, and anti-hepatitis C virus. The composite endpoint of biopsy-proven acute rejection, graft loss, or death was reached in four patients, with a mean time to event of 3.81 months. Infections were noted in 34 subjects but, no malignancies. Among 389 adverse events reported in 91 patients (90.1%), the majority were of mild to moderate severity. Two deaths were reported: heart transplant recipients with acute rejection and cytomegalovirus meningitis with respiratory failure. Long-term enrollment with follow-up evaluation of these NODM patients up to 3 years will help evaluate the NODM incidence rates and exact graft survival and overall survival rates of CsA-treated transplant patients in Taiwan.

Original languageEnglish
Pages (from-to)661-666
Number of pages6
JournalTransplantation Proceedings
Volume44
Issue number3
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

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Taiwan
Cyclosporine
Diabetes Mellitus
Transplants
Mycophenolic Acid
Immunosuppressive Agents
Transplantation
Maintenance
Incidence
Graft Rejection
Graft Survival
HDL Lipoproteins
Cytomegalovirus
Meningitis
Respiratory Insufficiency
Hepacivirus
Allografts
Adrenal Cortex Hormones
Body Mass Index
Survival Rate

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

New-onset diabetes mellitus in cyclosporine-treated organ transplant patients in Taiwan : Interim analysis (6 months) of postmarketing surveillance. / Tian, Y. F.; Tsai, C. S.; Lee, P. C.; Chu, S. H.; Chien, Y. S.; Loong, C. C.; Chen, C. H.; Wu, M. S.; Chu, S. H.; Lian, J. D.

In: Transplantation Proceedings, Vol. 44, No. 3, 04.2012, p. 661-666.

Research output: Contribution to journalArticle

Tian, Y. F. ; Tsai, C. S. ; Lee, P. C. ; Chu, S. H. ; Chien, Y. S. ; Loong, C. C. ; Chen, C. H. ; Wu, M. S. ; Chu, S. H. ; Lian, J. D. / New-onset diabetes mellitus in cyclosporine-treated organ transplant patients in Taiwan : Interim analysis (6 months) of postmarketing surveillance. In: Transplantation Proceedings. 2012 ; Vol. 44, No. 3. pp. 661-666.
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abstract = "Posttransplant new-onset diabetes mellitus (NODM) is an important complication among patients receiving immunosuppressants. It has a considerable impact on chronic allograft dysfunction. Calcineurin inhibitors have been implicated in the development of posttransplant NODM. Since high-risk candidates also undergo transplantation, prevention and control of posttransplant NODM is important. A 3-year postmarketing surveillance study is currently underway in Taiwan to evaluate the incidence and risk factors leading to development of NODM among de novo and maintenance solid-organ transplant patients receiving cyclosporine (CsA)-based immunosuppressive therapy. Concomitant therapy consisted of basiliximab, mycophenolate mofetil or enteric-coated mycophenolate sodium, and corticosteroids. Diabetes was diagnosed according to the American Diabetes Association criteria. This 6-month protocol-defined interim analysis included 101 patients (84 de novo, 17 maintenance) who received renal (n = 77), liver (n = 13), or heart (n = 11) transplantation. At the end of 6 months, 8/101 (7.92{\%}) patients experienced NODM. The mean time to NODM was 3.05 months. No significant difference was observed between NODM and non-NODM patients for risk factors: age, body mass index, blood pressure, gender, high-density lipoproteins/triglycerides hdl/tg, and anti-hepatitis C virus. The composite endpoint of biopsy-proven acute rejection, graft loss, or death was reached in four patients, with a mean time to event of 3.81 months. Infections were noted in 34 subjects but, no malignancies. Among 389 adverse events reported in 91 patients (90.1{\%}), the majority were of mild to moderate severity. Two deaths were reported: heart transplant recipients with acute rejection and cytomegalovirus meningitis with respiratory failure. Long-term enrollment with follow-up evaluation of these NODM patients up to 3 years will help evaluate the NODM incidence rates and exact graft survival and overall survival rates of CsA-treated transplant patients in Taiwan.",
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