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New Onset Diabetes Mellitus in Patients Receiving Calcineurin Inhibitors: A Systematic Review and Meta‐Analysis
Author(s) -
Heisel Olaf,
Heisel Rochelle,
Balshaw Robert,
Keown Paul
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1046/j.1600-6143.2003.00372.x
Subject(s) - medicine , tacrolimus , calcineurin , diabetes mellitus , incidence (geometry) , meta analysis , transplantation , surgery , endocrinology , physics , optics
New onset diabetes mellitus (NODM) is a serious complication of transplantation. This meta‐analysis evaluates the reported incidence of NODM after solid organ transplantation in patients receiving CNI treatment.Databases from January 1992 to April 2002 were searched. Fifty‐six publications providing NODM incidence data were reviewed. Sixteen prospective, randomized comparative studies providing information on incidence of insulin‐dependent diabetes mellitus (IDDM) were subjected to meta‐analysis.New onset diabetes mellitus was reported in 13.4% of patients after solid organ transplantation, with a higher incidence in patients receiving tacrolimus than cyclosporine (16.6% vs. 9.8%). This trend was observed across renal, liver, heart and lung transplant groups. Meta‐analysis of 16 studies included patients receiving either tacrolimus (n = 1636) or cyclosporine (n = 1407). The incidence of IDDM was significantly higher among tacrolimus‐treated patients (10.4% vs. 4.5%, p < 0.00001), an effect observed in renal (9.8% vs. 2.7% p < 0.00001) and nonrenal (11.1% vs. 6.2%; p < 0.003) groups, and among patients receiving equal doses of concomitant medication in both treatment arms (12.0% vs. 3.0%; p < 0.00001).The reported incidence of NODM during the past decade was significantly higher among patients receiving tacrolimus than cyclosporine. These data provide a quantitative foundation for studies designed to reduce the rates of NODM following solid organ transplantation.