Results in 386 patients CSWD (n = 191), CCS (n = 195) are presented (CSWD; CCS). No differences were observed at 5 years in the proportion of patients experiencing: primary end point (composite of death, graft loss, or moderate/severe acute rejection) (30/191 (%); 28/195 (%)), patient death (11/191(%);13/195 (%)), death-censored graft loss (11/191 (%); 7/195(%)), biopsy confirmed acute rejection (BCAR) (34/191 (%); 21/195 (%), P = ), moderate/severe acute rejection (15/191 (%); 12/195 (%)). Kaplan Meier analyses of the primary end point and its components also showed no differences; but BCAR was higher with CSWD (P = ). Increased BCAR episodes were primarily corticosteroid-sensitive Banff 1A rejections: the incidence of antibody-treated BCAR was similar between groups (11/191 (%); 13/195 (%)). No differences in renal function were observed at 5 years: mean serum creatinine ( +/- ; +/- mg/dL), or Cockroft Gault calculated creatinine clearance ( +/- ; +/- mL/min). CSWD was associated with improved serum triglycerides (evaluated by mean and median change from baseline) at all time points (except at 5 years measured by mean change). Weight change also demonstrated changes favoring CSWD (median change from baseline at 5 years: vs. kg, P = ). New onset diabetes after transplant (NODAT) was similar with respect to proportions who required treatment (23/107 (%)); 18/86 (%); however, fewer CSWD patients required insulin for NODAT at 5 years (4/107 (%)); 10/86 (%), P = ). Changes in HgA1c values (from baseline) were lower in CSWD patients at all time points except 4 years.
Corticosteroid withdrawal symptoms may develop when abruptly discontinuing the use of these drugs. These symptoms may include gastrointestinal disturbances, fatigue, or low blood pressure . Additional symptoms may include muscle and joint pain, headaches, and fever. Some of these symptoms may be reduced or avoided by tapering off the use of the medications slowly, although this does not completely eliminate the chances of experiencing negative side effects. Any specific questions or concerns about corticosteroid withdrawal in an individual situation should be discussed with a doctor or other medical professional.