{"id":330,"date":"2015-01-06T11:21:24","date_gmt":"2015-01-06T11:21:24","guid":{"rendered":"https:\/\/www.transplantevidence.com\/blog\/?p=330"},"modified":"2015-01-06T11:21:24","modified_gmt":"2015-01-06T11:21:24","slug":"sirolimus-associated-with-less-malignancy-but-an-increased-mortality-after-kidney-transplantation","status":"publish","type":"post","link":"https:\/\/www.transplantevidence.com\/news\/2015\/01\/06\/sirolimus-associated-with-less-malignancy-but-an-increased-mortality-after-kidney-transplantation\/","title":{"rendered":"Sirolimus associated with less malignancy but an increased mortality after kidney transplantation"},"content":{"rendered":"<p>A group from Ottawa, led by Greg Knoll, have published <a title=\"BMJ article\" href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g6679\" target=\"_blank\">an important systematic review<\/a> of risk of cancer in patients who had sirolimus included with their immunosuppression de novo as well as those who were converted at some stage after transplantation to sirolimus. The study also included a meta-analysis of individual patient data. This was available from 5,676 patients from 21 randomised trials. Sirolimus was associated with a 40% reduction in the risk of malignancy and particularly in the reduction of the risk of a non-melanoma skin cancer, compared with patients who did not receive sirolimus. The most marked effect was seen in patients who were converted to sirolimus at some time following the transplant procedure.<\/p>\n<p>However sirolimus was associated with a 43% increased risk of death compared with controls. The causes of death in sirolimus patients were either infection or\u00a0cardiovascular.\u00a0The authors suggest that although there is a reduction in the risk of malignancy, the increased risk of death in patients receiving sirolimus does not justify its use. This may well be true but this is a critically important\u00a0study and no doubt will trigger others to look specifically at mortality in their patients who are receiving, or have received, an mTOR inhibitor.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A group from Ottawa, led by Greg Knoll, have published an important systematic review of risk of cancer in patients who had sirolimus included with their immunosuppression de novo as well as those who were converted at some stage after transplantation to sirolimus. The study also included a meta-analysis of individual patient data. This was [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[177],"tags":[249,278,292],"class_list":["post-330","post","type-post","status-publish","format-standard","hentry","category-reviews","tag-meta-analysis","tag-renal-transplantation","tag-systematic-review"],"_links":{"self":[{"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/posts\/330","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/comments?post=330"}],"version-history":[{"count":0,"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/posts\/330\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/media?parent=330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/categories?post=330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.transplantevidence.com\/news\/wp-json\/wp\/v2\/tags?post=330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}