Everolimus: A Proliferation Signal Inhibitor with Clinical Applications in Organ Transplantation, Oncology, and Cardiology

被引:81
作者
Gabardi, Steven [1 ,2 ,3 ,5 ]
Baroletti, Steven A. [4 ]
机构
[1] Brigham & Womens Hosp, Dept Pharm Serv, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Transplant Surg, Boston, MA 02115 USA
[3] Harvard Univ, Sch Med, Boston, MA USA
[4] MetroW Med Ctr, Dept Pharm Serv, Framingham, MA USA
[5] Brigham & Womens Hosp, Div Renal, Boston, MA 02115 USA
来源
PHARMACOTHERAPY | 2010年 / 30卷 / 10期
关键词
everolimus; drug-eluting stent; heart transplant; immunosuppressant; mammalian target of rapamycin; mTOR inhibitor; percutaneous coronary intervention; renal cell carcinoma; renal transplant; solid organ transplant; CORONARY-ARTERY-DISEASE; SIROLIMUS-ELUTING STENTS; RENAL-CELL CARCINOMA; KIDNEY-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; DOUBLE-BLIND; REAL-WORLD; FOLLOW-UP; PHASE-II; SDZ RAD;
D O I
10.1592/phco.30.10.1044
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Everolimus, a proliferation signal inhibitor in the mammalian target of rapamycin (mTOR) drug class, has many clinical applications, including in organ transplantation, oncology, and cardiology. It currently has United States Food and Drug Administration (FDA) approval for prophylaxis against rejection in de novo renal transplant recipients, treatment of renal cell carcinoma, and use as a drug-eluting stent. To review the pharmacology, pharmacokinetics, efficacy, and safety of everolimus, we performed a search of the MEDLINE database (January 1997 April 2010) for all English-language articles of in vitro and in vivo studies that evaluated everolimus, as well as abstracts from recent scientific meetings and the manufacturer. In transplantation, everolimus demonstrates immunosuppressive properties and has been used to prevent acute rejection in cardiac, liver, lung, and renal transplant recipients. It appears that this agent may be potent enough to allow for the minimization or removal of calcineurin inhibitors in the long-term management of renal transplant recipients. In oncology, everolimus has been proven effective for the management of treatment-resistant renal cell carcinoma. In cardiology, everolimus is available as a drug-coated stent and is used in percutaneous coronary interventions for prevention of restenosis. In transplant recipients and patients with renal cell carcinoma, everolimus appears to have an extensive adverse-event profile. The pharmacologic properties of everolimus differentiate this agent from other drugs used in these clinical areas, and its pharmacokinetic properties differentiate it from sirolimus.
引用
收藏
页码:1044 / 1056
页数:13
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