Diabetogenicity of Cyclosporine and Tacrolimus
Summary
Cyclosporine (CsA) and Tacrolimus (Tac) are immunosuppressive agents comprising the cornerstone of treatment among organ transplant recipients. Unfortunately diabetes is a known complication after transplantation, yet the underlying mechanisms of this type of diabetes are still unresolved. A direct comparison of the diabetogenic effects of CsA and Tac, without interference of corticosteroid treatment, has not yet been investigated using a hyperinsulinemic euglycemic glucose clamp technique, which is the best method for estimating insulin sensitivity. Randomized, investigator-blinded cross-over studies will be carried out, studying 10 healthy subjects and 10 hemodialysis patients. Each participant will receive treatment with CsA, Tac and placebo respectively in a random order. The results will be of relevance to the choice and monitoring of immunosuppressive regimens in kidney transplant recipients as well as the development of better treatment modalities for diabetes.
Timeline
- Start
- 2008-03
- Primary completion
- 2010-06
- Completion
- 2011-11
Publications
- Ozbay LA, Stubbe J, Jespersen B, Jensen BL. The effects of calcineurin inhibitors on prostanoid synthesis: a randomized cross-over study in healthy humans. Transpl Int. 2013 Feb;26(2):131-7. doi: 10.1111/tri.12004. Epub 2012 Nov 29.
- Ozbay LA, Moller N, Juhl C, Bjerre M, Carstens J, Rungby J, Jorgensen KA. The impact of calcineurin inhibitors on insulin sensitivity and insulin secretion: a randomized crossover trial in uraemic patients. Diabet Med. 2012 Dec;29(12):e440-4. doi: 10.1111/dme.12028.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Cyclosporine | Peptide | 0.155 mg/kg | Intravenous |
| Subject | Cyclosporine | Peptide | 4 mg/kg | Intravenous |
| Subject | Tacrolimus | Small molecule | 0.0012 mg/kg | Intravenous |
| Subject | Tacrolimus | Small molecule | 0.1 mg/kg | Intravenous |