The Pharmaceutical Journal
Vol 268 No 7188 p311-320
9 March 2002

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The Lancet (www.thelancet.com)

Tacrolimus may lead to fewer rejections

Tacrolimus (Prograf) is more effective than a microemulsion formulation of ciclosporin (Neoral) in preventing acute rejection after renal transplantation, a study published in The Lancet shows.

However, Novartis, manufacturer of Neoral, said that the study was not blinded and that tacrolimus has not been proven to be superior to Neoral in a blinded setting. The company added that the initial oral daily dose of ciclosporin (8-10mg/kg) used in the study was below the recommended starting dose, which has important implications for acute rejection.

The researchers who conducted the current study report that the rates of acute rejection and corticosteroid-resistant rejection were lower with tacrolimus than with ciclosporin. They add that tacrolimus has a potentially superior cardiovascular risk profile compared with ciclosporin microemulsion (2002;359:741).