Newer immunosuppressive drugs : A review

In recent years, many new immunosuppressive drugs have been discovered and developed for clinical use in transplantation. This review focuses on those drugs (leflunomide, mycophenolate mofetil, sirolimus, tacrolimus) that have been shown to have immunosuppressive activity in patients. Different anti...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 1999-06, Vol.10 (6), p.1366-1380
Main Authors: GUMMERT, J. F, IKONEN, T, MORRIS, R. E
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Clinical Trials as Topic
Humans
Immunomodulators
Immunosuppressive Agents - pharmacology
Immunosuppressive Agents - therapeutic use
Isoxazoles - pharmacology
Isoxazoles - therapeutic use
Leflunomide
Medical sciences
Mycophenolic Acid - analogs & derivatives
Mycophenolic Acid - pharmacology
Mycophenolic Acid - therapeutic use
Pharmacology. Drug treatments
Sirolimus - pharmacology
Sirolimus - therapeutic use
Tacrolimus - pharmacology
Tacrolimus - therapeutic use
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Summary:In recent years, many new immunosuppressive drugs have been discovered and developed for clinical use in transplantation. This review focuses on those drugs (leflunomide, mycophenolate mofetil, sirolimus, tacrolimus) that have been shown to have immunosuppressive activity in patients. Different anti-interleukin-2 receptor antibodies are also reviewed as an example of a resurgence of development in the area of monoclonal antibodies. The price for reducing the incidence of allograft rejection by improved immunosuppression was thought to be a proportional increase in the incidence of infection and malignancy. Data from Phase III clinical trials of new immunosuppressants, however, show a statistically significant reduction in the incidence of acute rejection produced by these new drugs, which has not been accompanied by increases in infection and malignancy rates. The wide array of new drugs offers the opportunity to use combinations that block different pathways of immune activation while at the same time selecting drug combinations with nonoverlapping toxicity profiles so that doses of each single drug can be reduced below toxicity levels. The immunosuppressive therapy for patients can be tailored according to their individual needs.
ISSN:1046-6673
1533-3450
DOI:10.1681/ASN.V1061366