Aim: A once-daily formulation of tacrolimus, Advagraf®, is increasingly being used in place of twice-daily
tacrolimus, Prograf®, as a standard immunosuppressive agent for transplant patients. In this study, the
clinical safety and efficacy of Advagraf® were compared with Prograf®, among multi-ethnic Malaysian renal
transplanted population.
Method: This retrospective study identified renal transplant patients who were converted from Prograf® to
Advagraf® at the University Malaya Medical Centre (UMMC) (n=69). Clinical notes and laboratory records,
including tacrolimus daily dose and trough levels, were obtained for one-year, pre-and post-conversion. Causality
assessment of suspected adverse events were based on the WHO-Uppsala Monitoring Center criteria. Renal
biopsy records were re-evaluated based on the updated Banff 2007 classification for biopsy-confirmed acute
rejection (BPAR).
Results: Following conversion to Advagraf®, the mean tacrolimus trough level and daily dose decreased
significantly (p