Fluvastatin in combination with cyclosporin in renal transplant recipients: a review of clinical and safety experience

Cardiovascular disease remains a significant cause of morbidity and mortali ty in patients who have undergone renal transplantation, with one of the ma in risk factors being post-transplantation hyperlipidaemia. To date, howeve r, optimal management of elevated lipid levels in such patients has been hi ndered by the lack of both effective and safe treatments, coupled with conc erns over probable interactions with immunosuppressive therapy, particularl y cyclosporin. Numerous studies confirm that the 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors, such as fluvastatin, are effect ive lipid-lowering agents in renal transplant recipients, supporting findin gs in other patients' groups. Moreover, based on investigations of metaboli c profile and clinical observation, fluvastatin (at dosages of up to 80 mg/ day) is well tolerated in renal transplant recipients receiving cyclosporin . In clinical trials to date, no instances of rhabdomyolysis have been obse rved during co-administration of fluvastatin and cyclosporin. The potential of fluvastatin for improving survival in renal transplant recipients, in t erms of both cardiovascular mortality and graft rejection, is currently bei ng investigated in two ongoing studies: ALERT (Assessment of Lescol. [fluva statin] in Renal Transplantation) and SOLAR (Study of Lescol [fluvastatin] in Acute Rejection). The results of these landmark studies should confirm t he safe utility of fluvastatin in the renal transplantation setting.