pISSN 1226-6051
eISSN 2508-786X

Table. 2.

Table. 2.

Results of the survey to select clinical questions of recommendations on immunosuppressive therapies

QuestionsSurvey 1Survey 2

Importance (%)Agreement (%)
Induction therapy
I-1Is it effective to use immunosuppressants before the kidney transplantation?86.472.7
I-2Is biological agents effective for induction therapy?78.836.4
I-3In patients at low or moderate immunological risk, is IL2-RA effective?75.6100
I-4In patients at high immunological risk, is lymphocyte depleting antibodies effective?72.0100

Maintenance therapy (initial)
M-1Is combination treatment of immunosuppressants as maintenance therapy effective to prevent the rejection after transplantation?84.0100
M-2Which CNI is safe and effective for the first-line maintenance therapy?80.0100
M-3Should CNI treatment be initiated before transplantation?73.618.2
M-4Who needs to change from immediate release formulated tacrolimus to slow release formulation for maintenance therapy?68.836.4
M-5Is it effective to change from TAC to CSA or mTOR inhibitors, if the patients suffer intolerable or adverse reactions to tacrolimus?75.236.4
M-6Which antimetabolites is the first-line as maintenance therapy?79.636.4
M-7Is mycophenolates more effective and safe than azathioprine or mizoribine as an initial maintenance therapy?-100
M-8Does MMF provide equivalent efficacy and tolerability with MPS?74.436.4
M-9Is it safe to discontinue steroids early for patients with low immunological risk?58.4-
M-10Is it safe to use mTOR inhibitors in early transplantation period?72.418.2

Maintenance therapy (long-term)
M-11What is the most effective and safe regimen for long term maintenance therapy?67.645.5
M-12Is it effective and safe to continue CNI-based immunosuppressive therapy?77.245.5
M-13Is it safe to continue at low dose if steroids are not withdrawn?73.272.7
M-14Is it the most efficient method to measure blood levels of CNIs for monitoring immunosuppressive effects?82.854.5
M-15What is the most appropriate parameter to monitor the effects of CSA?69.045.5
M-16What is the most appropriate parameter to monitor the effects of TAC?74.445.5
M-17When is the best time for taking blood sample to monitor the levels of CNIs?66.045.5
M-18Should therapeutic levels of mycophenolates be monitored?56.4-
M-19Should therapeutics levels of mTOR inhibitors be monitored?71.227.3

Rejection therapy
R-1Should biopsy-proven borderline change be treated?72.0100
R-2What is the first-line therapy to treat acute rejection?85.272.7
R-3What is the most appropriate corticosteroids regimen to treat T-cell mediated acute rejection?-100
R-4Is it effective to continue steroids after acute rejection treatment?74.036.4
R-5Is it effective to treat with lymphocyte depleting agents for refractory or relapsed acute cellular rejection after corticosteroids treatment?70.818.2
R-6Which treatments is the most effective for antibody mediated acute rejection?83.2100
R-7Which treatment is the most effective for acute rejection on antibody incompatible transplantation?71.663.6
R-8Which is the most effective and safe antimetabolites after treating acute rejection?64.418.2

Desensitization therapy
D-1Which treatment is the most effective as desensitization therapy for ABO incompatibility or HLA sensitized kidney transplantation?-100

CNI, calcineurin inhibitors; CSA, cyclosporine; HLA, human leukocyte antigen; IL2-RA, interleukin-2 receptor antagonists; MMF, mycophenolate mofetil; MPS, mycophenolate sodium; mTOR, mammalian target of rapamycin; TAC, tacrolimus

Korean J Clin Pharm 2019;29:18-24 https://doi.org/10.24304/kjcp.2019.29.1.18
© 2019 Korean J Clin Pharm