Tacrolimus More Effective Than Cyclosporin

The use of Fujisawa's tacrolimus (formerly FK506) was associated with a significant reduction in acute, refractory and chronic rejection episodes in liver transplantation, according to the results of the European FK506 Multicenter Liver Study Group published in The Lancet (August 13).

In the study, 545 patients were randomized to either tacrolimus plus low-dose corticosteroids or a conventional cyclosporin-based regimen. The analysis was both by intention to treat and by efficacy population.

In the early phase of the study, the median initial intravenous tacrolimus dose administered (0.11mg/kg per day) was 80% greater than that for the main phase (0.06mg/kg). Patients on tacrolimus could be converted from intravenous to oral administration earlier in the postoperative period, say the trialists, because unlike cyclosporin, tacrolimus does not require normal biliary flow for oral absorption. The median was three days for tacrolimus and 12 days for cyclosporin.