What is the difference between sirolimus and tacrolimus?

Sirolimus can be used alone or in combination with a calcineurin inhibitor (such as tacrolimus) and/or mycophenolate mofetil to provide a steroid-free immunosuppressive regimen. Poor wound healing and thrombocytopenia may be side effects of sirolimus. Tacrolimus is the basic immunosuppressant after combined pancreas-kidney (SPK) transplantation and may cause nephrotoxicity and diabetes.

Tacrolimus and sirolimus-based immunosuppressive regimens were prospectively compared in an open, randomized, single-center, 5-year follow-up study. At 3 months, tacrolimus was continued or replaced by sirolimus. At 1 year, the differences in kidney and pancreas graft survival between sirolimus and tacrolimus were 0% and 6%, respectively. There was no difference in 5-year kidney and pancreas graft survival, with 34 patients (68%) in the sirolimus group requiring definite discontinuation compared with 3 patients (6%) in the tacrolimus group. Although sirolimus is noninferior to tacrolimus in terms of kidney and pancreas graft survival, the high discontinuation rate of sirolimus does not support its use as baseline therapy after SPK transplantation.

SirolimusThe original drug has been launched in China and has entered the scope of Class B medical insurance. SpecificationsThe price of each box of 1mg*10 tablets is about 400 yuan. The domestic drug is only available to patients with anti-rejection reactions in organ transplantation. Patients who do not meet the conditions may not be able to purchase this drug. The original sirolimus drug has also been launched overseas. The price of the Turkish version of Specifications1mg*100 tablets per box is around RMB 2,000 (the price may fluctuate due to exchange rates). The ingredients of the original drugs marketed in China are basically the same as those of foreign original drugs. Currently, there are no generic sirolimus drugs produced in other countries.