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How to Use mTOR Inhibitors? The Search Goes On

Flechner et al. compared two sirolimus-based strategies with standard therapy in 469 de novo, standard-risk renal allograft recipients. Patients were randomized into one of three groups: group 1 was a sirolimus-based calcineurininhibitor (CNI) withdrawal strategy with initial sirolimus and tacrolimus combination therapy followed by tacrolimus withdrawal 3 months after transplantation; group 2 represented a CNI-avoidance strategy with sirolimus and mycophenolate mofetil (MMF) and group 3 consisted of a standard CNI-therapy with tacrolimus and MMF. All patients received Daclizumab induction and corticosteroids.