Prescription pattern and safety of immunosuppressive drugs in patients of renal transplant in IGIMS Patna - An observational study

Abstract

Objective: Survival of post renal transplant patients has been improved by the suppression of the recipient’s immune system by immunosuppressive agents. However, various adverse drug reactions are also associated with immunosuppressive agents. Keeping this in mind, present study was planned to study the prescriptions pattern of immunosuppressant drugs and to study adverse drug reactions associated with immunosuppressant drugs.
Materials and Methods: It was an observational and cross-sectional study. We have collected reported ADRs, prescriptions, IPD files and laboratory reports of 40 patients who had already undergone renal transplant prior to start of this study and 10 patients who undergone renal transplant after start of this study.
Result: Most patients were prescribed prednisolone + tacrolimus + MMF as immunosuppressive regimen (70%) followed by prednisolone + cyclosporine + MMF (22%). Prednisolone was prescribed to all patients. Tacrolimus was prescribed to 72% of patients. Total 78 ADRs were reported from 50 patients in our study (incidence rate 68%). Drug MMF was mostly associated with ADRs (35.90%) followed by tacrolimus (29.49%), prednisolone (19.23%) and cyclosporine (15.38%). Most of the ADRs was mild (65.38%) while only one ADR was severe.
Conclusion: Corticosteroid continues to be mainstay of therapy in post renal transplant patients. Calcineurin inhibitors were exclusively associated with nephrotoxicity. MMF was associated with most ADRs followed by tacrolimus. Most of the ADRs were mild and treated symptomatically.