Sirolimus Rapamycin
sirolimus afinitor everolimus rapamune rapamycin
Avoid Wait for PKD Trials to Complete
Wait for PKD trials to complete. Avoid these mTor drugs for now.
Transplant
If individuals are already taking sirolimus for a transplanted organ, the Mayo is following ADPKD patients with PLD to keep a record of how their PLD liver size is doing. A PLD liver is reported to shrink while individuals are on sirolimus. Sirolimus also decreases metalloestrogens.FDA ALERT
The FDA has issued a warning about sirolimus. The FDA is notifying healthcare professionals of clinical trial data that suggest
increased mortality in stable liver transplant patients after conversion from a calcineurin inhibitor (CNI)-based immunosuppressive
regimen to sirolimus (Rapamune). The trial was conducted by sirolimus manufacturer, Wyeth. As early as 2002, Wyeth issued a warning
about not using sirolimus with liver transplantees. Below is an excerpt from that article:
Nephrotoxicity is a serious adverse effect after liver transplantation often related to calcineurin inhibitors (CNI) with a incidence
of 18.1% at 5 years. Sirolimus (SRL) is a new immunosuppressive drug that was introduced into solid organ transplant management in
1999. Herein we have performed a retrospective review of patients who developed renal insufficiency owing to CNI therapy after
orthotopic liver transplantation.
CONCLUSION:
calcineurin inhibitors CNIs may be associated with significant nephrotoxicity and chronic kidney damage. Patients who develop renal
dysfunction after OLT [ liver transplant] may be successfully treated by an early switch from CNIs to SRL, stopping the progression toward
chronic renal damage and preserving allograft survival. The trial showed that the switch from CNI to SRL caused an increase in death rates.
Everolimus (Afinitor)
Everolimus (afinitor) is also an mTor inhibitor and very similar to sirolimus. There was a German trial in humans for the treatment of PKD. It can also cause a shrinkage of a PLD liver. These are immunosuppressive drugs. FDA issued a warning following a trial that switching to sirolimus caused an increase in death rates. Afinitor, has many many side effects.
↓ PLD liver size
↓ PKD kidney growth
Slowed down kidney volume
↓ metalloestrogens
↑ death rates