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BMJ 2005;331 (8 October), doi:10.1136/bmj.331.7520.0-a
Whether tacrolimus or ciclosporin is the optimal choice for initial immunosuppression after kidney transplantation depends on the patient. Webster and colleagues (p 810) performed a meta-analysis and meta-regression of 30 randomised controlled trials to compare the positive and negative effects of the two drugs. Treatment with tacrolimus halved the risk of graft loss at six months compared with ciclosporin but almost doubled the risk of developing type 1 diabetes. Other side effects of tacrolimus included tremor, headache, diarrhoea, dyspepsia, and vomiting, whereas ciclosporin caused significantly more constipation and cosmetic side effects.
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Credit: SIMON FRASER/SPL
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