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Everolimus reduces weight gain post-LT compared with tacrolimus

The anti-rejection drug everolimus with reduced-exposure tacrolimus resulted in less weight gain after liver transplantation than standard tacrolimus immunosuppression therapy, according to a recently published study. Additionally, rates of posttransplant metabolic syndrome were comparable between both treatments.

“We found that two everolimus groups in this study gained around 10 pounds less than patients in the tacrolimus arm,” Michael Charlton, MD, researcher and clinician at Intermountain Medical Center Transplant Program, said in a press release. “It used to be that rejection was a big deal and that was the most common cause of liver rejection or death. Now, the most common cause of death following liver transplantation is related to cardiovascular events and cancers, with kidney function increasingly important as well. Cardiovascular disease, cancers and renal disease are driven in part by weight.”

The multicenter study comprised 719 patients who had undergone liver transplantation. Researchers randomly assigned patients at an average of 30 days posttransplant into one of three subgroups: patients receiving everolimus with reduced tacrolimus (n = 245), a tacrolimus control group (n = 243), and a tacrolimus elimination group (n = 231).

They compared weight change, assessed changes in vital signs, lipids and laboratory parameters, and assessed rates of posttransplant metabolic syndrome at 1 year and 2 years.

At 1 year, the mean weight increase from baseline was 5.88 kg in the everolimus group, 8.15 kg in the tacrolimus control group and 4.76 kg in the tacrolimus elimination group. At 2 years, the mean weight increase was 6.69 in the everolimus group, 9.45 kg in the tacrolimus control group and 6.01 kg in the tacrolimus elimination group.

Significantly lower weight gain was observed in the everolimus group compared with the tacrolimus control group for patients who had hypertension (systolic blood pressure 140 mm Hg) or a normal BMI (< 25) before transplant. Rates of posttransplant metabolic syndrome were similar in the everolimus group (80%), the tacrolimus control group (78.5%) and the tacrolimus elimination group (80.8%). Hyperlipidemia and stomatitis occurred more frequently in patients receiving everolimus compared with the other two group. – by Talitha Bennett

Disclosures : Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.