Everolimus vs tacrolimus in transplantation – pro
Studies at best show non-inferiority that must be balanced by the risk of changing efetive tacrolimus therapy. Everolimus can cause issues like wound healing problems, mouth sores (stomatitis), high cholesterol, and cytopenias (low blood counts). Tacrolimus is known for kidney toxicity (nephrotoxicity) and diabetes. Boumar et al did not observe efficacy differences between these two drugs.
Jeng LB, Lee SG, Soin AS, Lee WC, Suh KS, Joo DJ, Uemoto S, Joh J, Yoshizumi T, Yang HR, Song GW, Lopez P, Kochuparampil J, Sips C, Kaneko S, Levy G. Efficacy and safety of everolimus with reduced tacrolimus in living-donor liver transplant recipients: 12-month results of a randomized multicenter study. Am J Transplant. 2018 Jun;18(6):1435-1446. doi: 10.1111/ajt.14623. Epub 2018 Jan 25. PMID: 29237235.
Helio Tedesco-Silva et al, An overview of the efficacy and safety of everolimus in adult solid organ transplant recipients. Transplantation Reviews Volume 36, Issue 1, January 2022, 100655
R. Bouamar, N. Shuker, J.A.J. Osinga, M.C. Clahsen-van Groningen, J. Damman, C.C. Baan, J. van de Wetering, A.T. Rowshani, J. Kal-van Gestel, W. Weimar, T. van Gelder, D.A. Hesselink, Conversion from tacrolimus to everolimus with complete and early glucocorticoid withdrawal after kidney transplantation: a randomised trial. [The Netherlands Journal of Medicine] Issue: 2018 > January
Afinitor. Prescribing Information 2025