PMID- 36869621
OWN - NLM
STAT- MEDLINE
DCOM- 20230420
LR  - 20230426
IS  - 1399-3046 (Electronic)
IS  - 1397-3142 (Linking)
VI  - 27
IP  - 3
DP  - 2023 May
TI  - Assessment of the adverse effects of sirolimus versus everolimus in pediatric 
      heart transplant recipients.
PG  - e14487
LID - 10.1111/petr.14487 [doi]
AB  - BACKGROUND: Literature is limited comparing adverse effects (AEs) of the 
      proliferation signal inhibitors (PSIs) sirolimus (SRL) and everolimus (EVL) in 
      pediatric heart transplant (HTx) recipients. METHODS: Single-center, 
      observational cohort analysis assessing first use of SRL or EVL in pediatric HTx 
      recipients <21 years of age with up to 2 years follow-up between 2009 and 2020. 
      RESULTS: Eighty-seven patients were included, with 52 (59.8%) receiving EVL and 
      35 (40.2%) receiving SRL. Tacrolimus with PSI was the most common regimen. 
      Intergroup comparison revealed lower baseline estimated glomerular filtration 
      rate (eGFR) and greater increase in eGFR from baseline to 6 months and latest 
      follow-up in SRL cohort compared to EVL cohort. There was greater increase in HDL 
      cholesterol in SRL cohort compared to EVL cohort. Intragroup analysis revealed 
      eGFR and HDL cholesterol increased significantly within SRL cohort, triglycerides 
      and glycosylated hemoglobin increased in EVL cohort, and LDL cholesterol and 
      total cholesterol increased in both cohorts (all p < .05). There were no 
      differences in hematological indices or rates of aphthous ulcers, effusions, or 
      infections between cohorts. Incidence of proteinuria was not significantly 
      different among those screened within cohorts. Of those included in our analysis, 
      one patient in SRL cohort (2.9%) and two in EVL cohort (3.8%) had PSI withdrawn 
      due to AE. CONCLUSION: Low-dose PSIs in calcineurin inhibitor minimization 
      regimens appear well-tolerated with low withdrawal rate secondary to AE in 
      pediatric HTx recipients. While incidence of most AE was similar between PSI, our 
      results suggest EVL may be associated with less favorable metabolic impact than 
      SRL in this population.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Newland, David M
AU  - Newland DM
AUID- ORCID: 0000-0003-0037-8065
AD  - Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA.
AD  - School of Pharmacy, University of Washington, Seattle, Washington, USA.
FAU - Rosete, Beatrice E
AU  - Rosete BE
AUID- ORCID: 0000-0001-9106-7558
AD  - Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA.
AD  - School of Pharmacy, University of Washington, Seattle, Washington, USA.
FAU - Law, Yuk M
AU  - Law YM
AUID- ORCID: 0000-0002-4282-4812
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Kemna, Mariska S
AU  - Kemna MS
AUID- ORCID: 0000-0001-9484-3006
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Albers, Erin L
AU  - Albers EL
AUID- ORCID: 0000-0002-3072-4195
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Hong, Borah J
AU  - Hong BJ
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Ahmed, Humera
AU  - Ahmed H
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Spencer, Kathryn L
AU  - Spencer KL
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
FAU - Friedland-Little, Joshua M
AU  - Friedland-Little JM
AUID- ORCID: 0000-0001-6161-7651
AD  - Division of Pediatric Cardiology, Seattle Children's Hospital, Seattle, 
      Washington, USA.
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle, 
      Washington, USA.
LA  - eng
PT  - Journal Article
DEP - 20230303
PL  - Denmark
TA  - Pediatr Transplant
JT  - Pediatric transplantation
JID - 9802574
RN  - W36ZG6FT64 (Sirolimus)
RN  - 9HW64Q8G6G (Everolimus)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Calcineurin Inhibitors)
SB  - IM
MH  - Humans
MH  - Child
MH  - *Sirolimus/adverse effects
MH  - Everolimus/adverse effects
MH  - Immunosuppressive Agents/adverse effects
MH  - Cholesterol, HDL
MH  - Calcineurin Inhibitors/adverse effects
MH  - *Heart Transplantation
OTO - NOTNLM
OT  - adverse effects
OT  - everolimus
OT  - mammalian target of rapamycin inhibitors
OT  - pediatric heart transplant
OT  - proliferation signal inhibitors
OT  - sirolimus
EDAT- 2023/03/05 06:00
MHDA- 2023/04/20 06:41
CRDT- 2023/03/04 02:52
PHST- 2023/01/20 00:00 [revised]
PHST- 2022/05/31 00:00 [received]
PHST- 2023/01/24 00:00 [accepted]
PHST- 2023/04/20 06:41 [medline]
PHST- 2023/03/05 06:00 [pubmed]
PHST- 2023/03/04 02:52 [entrez]
AID - 10.1111/petr.14487 [doi]
PST - ppublish
SO  - Pediatr Transplant. 2023 May;27(3):e14487. doi: 10.1111/petr.14487. Epub 2023 Mar 
      3.