Observational study of characteristics and clinical outcomes of Dutch patients with tuberous sclerosis complex and renal angiomyolipoma treated with everolimus.

<h4>Objective</h4>To compare kidney size (used as proxy for total renal angiomyolipoma [rAML] size) and kidney function outcomes between patients with tuberous sclerosis complex (TSC) and rAML treated and not treated with everolimus.<h4>Methods</h4>Medical charts of adults wi...

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Main Authors: Bernard A Zonnenberg, Maureen P Neary, Mei Sheng Duh, Raluca Ionescu-Ittu, Jonathan Fortier, Francis Vekeman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0204646/1/pone.0204646.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210222%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210222T124907Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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Summary:<h4>Objective</h4>To compare kidney size (used as proxy for total renal angiomyolipoma [rAML] size) and kidney function outcomes between patients with tuberous sclerosis complex (TSC) and rAML treated and not treated with everolimus.<h4>Methods</h4>Medical charts of adults with TSC-associated rAML followed at a specialty medical center in the Netherlands (1990-2015). Included patients treated with everolimus (n = 33, of which 27 were included in the kidney size analyses and 27 in the kidney function analyses [21 patients in both]; index date = everolimus initiation) and non-treated patients (n = 39, of which 29 were included in the kidney size analyses and 33 in the kidney function analyses [23 patients in both]; index date = one date among all dates with outcome measurement).Percent change in kidney size and kidney function from the index date to the best measurement in the two years post-index date (best response) compared between patients treated and not treated with everolimus.<h4>Results</h4>Compared with non-treated patients, significantly more everolimus-treated patients experienced a reduction in the size of their largest kidney in the two years post-index date (85.2% vs. 37.9%, p < 0.01). Also, there was a tendency towards more improvement in the estimated glomerular filtration rate (eGFR) among the everolimus-treated patients (55.6% vs. 33.3%, p = 0.08).<h4>Conclusions</h4>The study results suggest that everolimus is effective in controlling and even reversing the growth of the kidneys, used as a proxy for rAML size, as well as preserving or improving kidney function in patients with TSC and rAML treated in a real-world, observational setting.
ISSN:1932-6203