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#TIL sirolimus is a maintenance IMS option for #LungTx patients with BOS to prevent further lung function decline. Observational data shows: sirolimus + tac (in pts > 1 yr post tx) is superior to MMF + tac for BOS free survival and survival overall. PMID:24119986 #TxPharm
However, 5 of the 24 patients in the sirolimus arm didn't tolerate sirolimus 
(leukopenia, rash, arthralgia and GI sx) and were converted back to mycophenolate. These pts were not included in the analysis.
(leukopenia, rash, arthralgia and GI sx) and were converted back to mycophenolate. These pts were not included in the analysis.
While the incidence of renal insufficiency was lower in the SIR treated group, the incidence of dyslipidemia and thromboembolic events was higher in the SIR group than the MMF group.
Usually we are limited by who we can use SIR in due to AE. #HotOffThePress is a population database analysis that demonstrates that mTORi had a significantly higher incidence of adverse effects compared to tac (CV, derm, endo, GI, MSK, ID, pulm, renal and vascular AE).
The CV 
related AE were present across all organ groups and included: arteriosclerosis, HF, hypotension, tachycardia, chest pain, edema and pericardial disorders.
#TxPharm #TwitteRx #MedTwitter #MedEd
PMID: 33476406
related AE were present across all organ groups and included: arteriosclerosis, HF, hypotension, tachycardia, chest pain, edema and pericardial disorders. #TxPharm #TwitteRx #MedTwitter #MedEd
PMID: 33476406
Because of the various toxicities associated with mTORi, they are usually reserved for patients who do not tolerate antimetabolites, have progressive CNI toxicity (maybe) or have progressive bronchiolitis obliterans syndrome. 
