Trends in Maintenance Immunosuppressive Drugs Used in Taiwanese Kidney Transplant Recipients: An Analysis of the National Health Insurance Research Database

Abstract

Trends in maintenance immunosuppressive drugs used among Taiwanese kidney transplant recipients have not been reported before. We examined the National Health Insurance Research Database to analyze trends in maintenance immunosuppressive drugs used in Taiwanese kidney transplant recipients for the years 2002–2009. The new case number of kidney transplant recipients ranged from 302 to 673 per year. In 2009, 5276 kidney transplant recipients received immunosuppressive therapy. The 5-year renal graft survival rate of kidney transplant recipients was 93%. In 2009, the most common immunosuppressive therapy among Taiwanese kidney transplant recipients was a triple regimen that included tacrolimus, mycophenolate mofetil, and corticosteroid. There was a significant increase in the use of a tacrolimus-based regimen from 35.1%–58.2%, while the use of cyclosporine decreased from 62.2%–24.8% (P < .05). The percentage of calcineurin inhibitor–free regimen increased from 2.7%–17%. Moreover, the use of Rapamune dramatically increased from 8.2%–22.6% in 2002–2004. However, the percentage of kidney transplant recipients using Rapamune maintained 23 ± 1.6% in 2004–2009. The use of mycophenolic acid remained stable at about 74.9 ± 3.2% in 2002–2009. As predicted, the use of Imuran decreased from 6.9%–3.5%. In summary, although calcineurin inhibitors remained the mainstay of immunosuppressive drugs, these findings suggest a general trends toward individualized regimens and the use of calcineurin inhibitor–free and mammalian target of rapamycin inhibitors–based regimens in Taiwanese kidney transplant recipients.