(HealthDay News) — For kidney transplant recipients, steroid avoidance has limited impact for reducing new-onset diabetes after transplantation, according to a study published in the American Journal of Transplantation.

John D. Pirsch, MD, from the University of Wisconsin in Madison, and colleagues examined whether steroid avoidance reduces the risk for new-onset diabetes after transplanation following kidney transplantation. 

Data were included from a 5-year early steroid withdrawal double-blind randomized trial. Using eight definitions, the incidence, timing and risk factors for new-onset diabetes after transplantation were assessed.


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By 5 years, 36.3% of patients on chronic corticosteroids and 35.9% on early corticosteroid withdrawal were diagnosed with new-onset diabetes after transplantation by the American Diabetes Association definition, the researchers found. Slightly more cases of new-onset diabetes after transplantation were identified with the definition combining fasting blood glucose ≥126 mg/dL on two occasions or treatment (chronic corticosteroids, 39.3% and early corticosteroid withdrawal, 39.4%). 

The proportion of patients with new-onset diabetes after transplantation requiring treatment through 5 years posttransplant was similar (early corticosteroid withdrawal, 22.5% and chronic corticosteroids, 21.5%); insulin therapy was lower with early corticosteroid withdrawal than chronic corticosteroids (3.7% vs. 11.6%; P=.049). 

Only age was a significant risk factor for new-onset diabetes after transplantation for more than one definition in multivariate analysis.

“This prospective, randomized trial of [early corticosteroid withdrawal] indicates that [early corticosteroid withdrawal] has a limited impact in reducing [new-onset diabetes after transplantation] when compared to low-dose prednisone (5 mg/day from month six to five years),” the researchers wrote.

Several authors are employees of Astellas Pharma Global Development and Astellas Scientific and Medical Affairs.

Reference

  1. Pirsch JD et al. Am J Transplant. 2015;15(7):1982-1990.