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  • 1
    In: Clinical Transplantation, Wiley, Vol. 33, No. 1 ( 2019-01)
    Abstract: Following heart transplantation (HT), HMG CoA reductase inhibitors (statins) have been shown to reduce total and low‐density lipoprotein (LDL) cholesterol, development of cardiac allograft vasculopathy (CAV), and mortality. Studies in HT patients have demonstrated the safety of low/moderate intensity statins; however, little data exist using high‐intensity (HI) statins. The study aim was to evaluate the safety and efficacy of HI statins in HT recipients receiving tacrolimus. Methods This single‐center, retrospective analysis included adult HT recipients from January 1, 2005, to December 31, 2015, who received HI statin therapy during posttransplant follow‐up. The primary outcome, tolerability, was defined as the absence of myalgias, hepatotoxicity, rhabdomyolysis, or HI statin dose reduction/discontinuation. The secondary end point was the mean reduction in total and LDL cholesterol. Results Among the 24 patients included, one experienced myalgias and therapy discontinuation (4%; P   〉  0.99). No other HI statin dose reduction/discontinuation occurred, and no instances of rhabdomyolysis or hepatotoxicity were observed. The average reduction in total and LDL cholesterol after conversion to HI statin was 35 mg/dL ( P  = 0.02) and 19 mg/dL ( P  = 0.10), respectively. Conclusions High‐intensity statin therapy appears safe and efficacious in HT recipients receiving tacrolimus and is a reasonable option for the treatment of refractory hyperlipidemia.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 2
    Online Resource
    Online Resource
    Wiley ; 2018
    In:  Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy Vol. 38, No. 7 ( 2018-07), p. 758-768
    In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Wiley, Vol. 38, No. 7 ( 2018-07), p. 758-768
    Abstract: This article summarizes available literature regarding the utilization of probiotic and synbiotics in liver transplant ( LTX ) recipients, reviewing efficacy in both decreasing infectious complications and immunomodulation, as well as exploring safety concerns. Data suggest that the use of probiotics containing Lactobacillus spp, either alone or in combination with prebiotics (referred to as synbiotics), may be effective in reducing infectious complications after LTX , a major contributor to graft loss, hospital length of stay, and mortality. Literature evaluating the use of probiotics to induce tolerance, reduce rejection, and prevent damage associated with ischemia–reperfusion injury is limited to animal models but compelling, as it suggests the use of probiotics may augment deleterious immune‐mediated processes in this population. While the benefits of probiotics should be weighed against potential risks, these concerns are largely theoretical in the LTX recipient, with the majority of evidence extrapolated from case reports in other immunosuppressed populations. Based on available literature, it may be prudent to avoid products containing Saccharomyces sp, as these were not used in the efficacy studies, and the majority of the adverse event reporting stems from the use of products containing this organism. Further evaluation of the safety and efficacy of probiotic therapy is warranted. Studies specifically designed to elucidate the optimal product and initiation scenario and delineate safety in this population are needed to allow expanded use of this inexpensive, relatively nontoxic, and potentially beneficial therapeutic option after LTX .
    Type of Medium: Online Resource
    ISSN: 0277-0008 , 1875-9114
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2061167-5
    SSG: 15,3
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