Triple therapy with cyclosporine, CellCept (Mofetil), and prednisone is becoming the standard chronic maintenance regimen in the USA for renal transplant patients. CellCept has replaced azathioprine and appears to be a more potent immunosuppressive drug. Yet the addition of greater immunosuppression has not yet been shown to result in the ability to reduce the doses of the other immunosuppressive agents. Previous experience with decreasing cyclosporine for financial reasons has demonstrated that the majority of patients could reduce their dose of cyclosporine without provoking acute rejection. We believe that this may also result in higher GFR, lower serum creatinine, lower blood pressure and improved plasma lipids. Also, decreasing the amount of cyclosporine would result in decreased costs. Depending on the results of this pilot study, we will resubmit a proposal to the company to increase the number of patients in order to increase the statistical power.
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