New Study Backs Tacrolimus Over Cyclosporine in Preventing Lung Transplant Complications - Video

A new study published in the Journal of Heart and Lung Transplantation has found that lung transplant recipients treated with twice-daily tacrolimus have significantly lower rates of chronic lung allograft dysfunction (CLAD) and better overall survival compared to those receiving cyclosporine. The findings are based on data from over 22,000 patients in the International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry.

CLAD is a major long-term complication following lung transplantation, leading to progressive and irreversible loss of graft function. Immunosuppressive medications such as calcineurin inhibitors—tacrolimus and cyclosporine—are widely used to help prevent rejection. However, whether one drug is more effective than the other had remained uncertain.

The new study is the first to demonstrate a clear survival benefit associated with

tacrolimus, particularly its immediate-release, twice-daily formulation. Among the 22,222 patients analyzed, 88.6% were on immediate-release tacrolimus. This group had a notably lower incidence of CLAD and improved survival outcomes compared to those treated with cyclosporine.

“This present study should reassure transplant patients and providers twice-daily tacrolimus — and not only once-daily tacrolimus — is the superior treatment to cyclosporine,” said Michael Combs, M.D., M.S., an assistant professor of pulmonary diseases and internal medicine at Michigan Medicine. “Importantly, in our study we found that twice-daily tacrolimus not only resulted in lower rates of CLAD relative to cyclosporine, but it was also associated with improved overall survival after lung transplantation. This is an important, patient-centered finding which has not been previously demonstrated.”

He added that future studies may help determine whether one tacrolimus formulation is definitively superior. Until then, the study supports tacrolimus as the preferred option for lung transplant patients.

Reference: https://www.michiganmedicine.org/health-lab/most-effective-prevention-method-complications-post-lung-transplant