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Khan E, Killackey M, Kumbala D, et al. Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients. World J Nephrol. 2014;3(3):107-13doi: 10.5527/wjn.v3.i3.107.
Khan, E., Killackey, M., Kumbala, D., LaGuardia, H., Liu, Y. J., Qin, H. Z., Alper, B., Paramesh, A., Buell, J., & Zhang, R. (2014). Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients. World journal of nephrology, 3(3), 107-13. https://doi.org/10.5527/wjn.v3.i3.107
Khan, Enver, et al. "Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients." World journal of nephrology vol. 3,3 (2014): 107-13. doi: https://doi.org/10.5527/wjn.v3.i3.107
Khan E, Killackey M, Kumbala D, LaGuardia H, Liu YJ, Qin HZ, Alper B, Paramesh A, Buell J, Zhang R. Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients. World J Nephrol. 2014 Aug 06;3(3):107-13. doi: 10.5527/wjn.v3.i3.107. PMID: 25332902; PMCID: PMC4202487.
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World J Nephrol. 2014 Aug 06;3(3):107-13. doi: 10.5527/wjn.v3.i3.107.

Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients.

World journal of nephrology

Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang

Affiliations

  1. Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.

PMID: 25332902 PMCID: PMC4202487 DOI: 10.5527/wjn.v3.i3.107

Abstract

AIM: To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipients.

METHODS: From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure (Group 1), while 149 patients did not receive any ketoconazole (Group 2). A combination of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction.

RESULTS: Basic demographic data was similar between the 2 groups. The 5-year cumulative incidence of biopsy-confirmed and clinically-treated acute rejection was significantly higher in Group 1 than in Group 2 (34% vs 18%, P = 0.01). The 5-year Kaplan-Meier estimated graft survival (74.3% vs 76.4%, P = 0.58) and patient survival (87.8% vs 87.5%, P = 0.93) were not different between the 2 groups. Multivariable analyses identified ketoconazole usage as an independent risk of acute rejection (HR = 2.33, 95%CI: 1.33-4.07; P = 0.003) while tacrolimus dose in the 2(nd) month was protective (HR = 0.89, 95%CI: 0.75-0.96; P = 0.041).

CONCLUSION: Co-administration of ketoconazole and tacrolimus is associated with significantly higher incidence of acute rejection in kidney transplant recipients.

Keywords: Cytochrome P450; Kidney transplant; Pharmacokinetics; Rejection; Survival; Tacrolimus Ketoconazole

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