UC study could reduce use of steroids for transplant patients

07/24/06, Cincinnati Business Courier

Reducing corticosteroid treatment in kidney transplant patients may reduce the side effects of anti-rejection drugs, according to preliminary results of a study led by University of Cincinnati scientists.

"When you ask transplant patients about their medicines, they say the drug they dislike most is steroids. They don't want to take steroids because of what the drugs do to their bodies," Dr. Steve Woodle, principal investigator for the study. "They see how the drug's toxicity affects their bodies -- their faces swell, they gain weight, they bruise easily -- and they know steroids are the cause."

Steroids are typically given in combination with other drugs that help suppress the body's immune system and allow the transplanted organ to function properly. Previous research has linked them to an increased risk for cardiovascular disease, high cholesterol and blood pressure, weight gain, diabetes and cataracts. In adolescent and pediatric patients, the drugs can even hinder physical growth.

Despite the side effects, physicians have feared that removing them would increase the risk for organ rejection.

"This study shows that, when used in combination with the right immunosuppressive agents, we can minimize that risk for rejection while also reducing the negative side effects associated with steroid use," Woodle said.

Specifically, he said, a seven-day treatment with synthetic steroids known as corticosteroids, in conjunction with immunosuppressive agents, is as effective as long-term corticosteroid therapy in kidney transplant patients three years after transplant.

The Cincinnati team's findings were reported today at the meeting of the World Transplant Congress in Boston.

This UC-led multicenter trial is the first in which corticosteroids were removed prior to 90 days after kidney transplant and is one of four double-blind, randomized trials of its kind ever conducted. The results presented were for the first three years of the projected five-year investigation.

The researchers found that patients who received just seven days of the corticosteroid prednisone after kidney transplant had the same transplant organ survival rate and functionality as those placed on continuous corticosteroids. In addition, patients on short-term steroids experienced significantly less cardiovascular risk, including cholesterol levels, blood pressure and weight gain.

The national trial enrolled 397 patients. It was conducted at 26 medical centers across the United States.

Woodle and other researchers received honoraria and nominal research grants from the study sponsor, Astellas Pharmaceuticals.