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Anti-rejection drug may increase risk of diabetes after kidney transplant
May 23, 2008For patients undergoing kidney transplantation, treatment with the anti-rejection drug sirolimus may lead to an increased risk of diabetes, reports a study in the July Journal of the American Society of Nephrology (JASN).
"We demonstrated a robust association between sirolimus and diabetes after transplantation in a large group of kidney transplant recipients in the United States," comments Dr. John S. Gill of University of British Columbia, Vancouver. "The risk of diabetes was independent of other factors that are known to increase the risk of diabetes."
The researchers analyzed US Renal Data System data on approximately 20,000 Medicare beneficiaries undergoing kidney transplantation between 1995 and 2003. None of the patients had diabetes before their kidney transplant. Treatment with sirolimus was analyzed as a possible contributor to the risk of diabetes developing after transplantation, along with other known and potential risk factors.
"Sirolimus is a newer type of anti-rejection drug that has not been associated with diabetes in transplant recipients," Dr. Gill explains. "However, a number of animal studies and small clinical studies have suggested that sirolimus may increase the risk of diabetes."
The results suggested a higher rate of post-transplant diabetes among patients treated with sirolimus, compared to other anti-rejection drugs. Depending on which additional drugs they received, diabetes risk was 36 to 66 percent higher for patients receiving sirolimus.
Separate analysis of patients who stayed on the same anti-rejection drugs throughout the first year after transplantation showed similar results. The increase in risk was unrelated to any of the other drugs used in combination with sirolimus, or to other risk factors such as age, race/ethnicity, or obesity.
Diabetes is a serious and increasingly common complication occurring after kidney transplantation. "Patients who develop diabetes after transplantation have roughly the same risk of transplant failure as patients who develop acute transplant rejection," says Dr. Gill. Several factors are known to increase the risk of post-transplant diabetes, including some other anti-rejection drugs. The new report is the first large clinical study to suggest that sirolimus may be a risk factor as well.
"Further studies should be done to further clarify the risk of diabetes in sirolimus-treated patients," Dr. Gill adds. He also notes some important limitations of the study, including the fact that it was based on a review of previous data and limited to Medicare patients.
American Society of Nephrology
"Sirolimus is a newer type of anti-rejection drug that has not been associated with diabetes in transplant recipients," Dr. Gill explains. "However, a number of animal studies and small clinical studies have suggested that sirolimus may increase the risk of diabetes."
The results suggested a higher rate of post-transplant diabetes among patients treated with sirolimus, compared to other anti-rejection drugs. Depending on which additional drugs they received, diabetes risk was 36 to 66 percent higher for patients receiving sirolimus.
Separate analysis of patients who stayed on the same anti-rejection drugs throughout the first year after transplantation showed similar results. The increase in risk was unrelated to any of the other drugs used in combination with sirolimus, or to other risk factors such as age, race/ethnicity, or obesity.
Diabetes is a serious and increasingly common complication occurring after kidney transplantation. "Patients who develop diabetes after transplantation have roughly the same risk of transplant failure as patients who develop acute transplant rejection," says Dr. Gill. Several factors are known to increase the risk of post-transplant diabetes, including some other anti-rejection drugs. The new report is the first large clinical study to suggest that sirolimus may be a risk factor as well.
"Further studies should be done to further clarify the risk of diabetes in sirolimus-treated patients," Dr. Gill adds. He also notes some important limitations of the study, including the fact that it was based on a review of previous data and limited to Medicare patients.
American Society of Nephrology
Diabetes Current Events and Diabetes News RSSESC to give talks on Diabetes in three cities in China
As a result of successful events organised last year, a second Joint Scientific Forum, organised by the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD), two of the most respected professional medical organisations in Europe, will be held from 27-29 November at three venues across China - Beijing, Shanghai and Guangzhou.
New research shows versatility of amniotic fluid stem cells
For the first time, scientists have demonstrated that stem cells found in amniotic fluid meet an important test of potential to become specialized cell types, which suggests they may be useful for treating a wider array of diseases and conditions than scientists originally thought.
First reconstitution of an epidermis from human embryonic stem cells
Stem cell research is making great strides. This is yet again illustrated by a study carried out by the I-STEM* Institute (I-STEM/ Inserm UEVE U861/AFM), published in the Lancet on 21 November 2009. The I-STEM team, directed by Marc Peschanski has just succeeded in recreating a whole epidermis from human embryonic stem cells.
An atomic-level look at an HIV accomplice
Since the discovery in 2007 that a component of human semen called SEVI boosts infectivity of the virus that causes AIDS, researchers have been trying to learn more about SEVI and how it works, in hopes of thwarting its infection-promoting activity.
Scripps research scientists find new link between insulin and core body temperature
A team led by scientists at The Scripps Research Institute have discovered a direct link between insulin-a hormone long associated with metabolism and metabolic disorders such as diabetes-and core body temperature.
Scientists find molecular trigger that helps prevent aging and disease
Researchers at Mount Sinai School of Medicine set out to address a question that has been challenging scientists for years: How do dietary restriction-and the reverse, overconsumption-produce protective effects against aging and disease?
Pivotal study for PSD502 -- the first potential treatment for premature ejaculation
At the annual meeting of the Sexual Medicine Society of North America (SMSNA), Inc. in San Diego, Sciele Pharma, Inc., a Shionogi Company and Plethora Solutions Limited, a wholly owned subsidiary of Plethora Solutions Holdings PLC ("Plethora" - AIM:PLE)., today presented data from its second positive pivotal study of PSD502 for the treatment of premature ejaculation (PE).
Night Beat, Overtime and a Disrupted Sleep Pattern Can Harm Officers' Health
A police officer who works the night shift, typically from 8 p.m. to 4 a.m., already is at a disadvantage when it comes to getting a good "night's" sleep.
Fat collections linked to decreased heart function
Researchers from Boston University School of Medicine (BUSM) have shown that fat collection in different body locations, such as around the heart and the aorta and within the liver, are associated with certain decreased heart functions.
Thoughtful words help couples stay fighting fit
Couples who bring thoughtful words to a fight release lower amounts of stress-related proteins, suggesting that rational communication between partners can ease the impact of marital conflict on the immune system.
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