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September 12, 1990

Medical News & Perspectives

JAMA. 1990;264(10):1225-1234. doi:10.1001/jama.1990.03450100013001

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New Antirejection Drugs Anticipated  TRANSPLANTATION is rapidly approaching a "postcyclosporine era," just 7 years after this potent immunosuppressive drug launched transplantation from experimental science into mainstream medicine.Recently, several new compounds—molecular daughters and granddaughters of cyclosporine—have proven in animal models to be safe and even more potent and effective than cyclosporine. Three in particular—FK506 (Fujisawa Pharmaceutical Co, Tsukuba, Japan), RS-61443 (Syntex Corp, Palo Alto, Calif), and rapamycin (Wyeth-Ayerst Laboratories, Philadelphia, Pa)—drew attention at the International Congress of the Transplantation Society in San Francisco, Calif last month.Most exciting was the evidence that these drugs act at different stages along the rejection pathway, including the stimulation and proliferation of lymphocytes and the production of antibodies. They appear to work synergistically with each other and with cyclosporine, with one notable exception: the toxic combination of FK506 and cyclosporine. It is hoped the additive effect of these drugs in low concentrations