Abstract: FR-PO1216
Effect of Calcineurin Inhibitor Neurotoxicities on Quality of Life in Kidney Transplant Recipients: Evidence from a Real-World Survey
Session Information
- Transplantation: Clinical - Rejection, Biomarkers, and Pharmacology
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Hashemi, Lobat, Veloxis Pharmaceuticals, Cary, North Carolina, United States
- Clayton, Sarah, Adelphi Real World, Bollington, England, United Kingdom
- Lowe, Mollie, Adelphi Real World, Bollington, England, United Kingdom
- Le Brocq, Laura, Adelphi Real World, Bollington, England, United Kingdom
- Weatherby, Sarah, Adelphi Real World, Bollington, England, United Kingdom
- Fowler, Kevin John, The Voice of the Patient, Saint Louis, Missouri, United States
- Peipert, John Devin, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, United Kingdom
- Taber, David J., Veloxis Pharmaceuticals, Cary, North Carolina, United States
Background
Calcineurin inhibitors (CNIs), the cornerstone therapy in kidney transplantation (KTX), often induce significant neurotoxicities. These issues are well known, but their impact on health-related quality of life (HRQoL) and medication adherence in a real world setting is not well studied.
Methods
Data were drawn from the Adelphi Real World Kidney Transplant Disease Specific Programme™, a cross-sectional survey, in the U.S. from Sept 2024 – Apr 2025. Physicians reported patient demographics and clinical characteristics of patients. Patients voluntarily completed the Adelphi Drug Adherence Questionnaire (ADAQ©), the EuroQol 5-Dimension 5-Level (EQ-5D-5L), the 12-item Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment questionnaire (WPAI), and the Functional Assessment of Chronic Illness Therapy-Calcineurin Inhibitor-Neurotoxicity (FACIT-CNI-NTX). Multiple linear mixed effects regressions were used to explore the relationship between CNI neurotoxicities, measured by the FACIT-CNI-NTX, and HRQoL outcomes (EQ-5D-5L Utility Index (US tariff), SF-12, and WPAI), and patient-reported adherence (ADAQ©).
Results
58 patients receiving CNIs were included, with a mean (SD) age of 54.9 (13.4); 43% were female, and mean (SD) time since transplant was 4.9 (6.0) years. Regression analysis demonstrated a significant relationship between FACIT-CNI-NTX cognitive side effects scale and the EQ-5D-5L (coefficient=0.07, p≤0.01), WPAI activity impairment (coefficient=-6.35, p≤0.01), ADAQ© (coefficient=-0.08, p≤0.01), and the SF-12 physical (coefficient=1.34, p≤0.01) and mental health composites (coefficient=1.23, p≤0.01). For all of these patient-reported measures, as the FACIT-CNI-NTX cognitive side effects increased, the HRQoL and medication adherence significantly decreased. A significant relationship was also observed between the FACIT-CNI-NTX tremors scale and the EQ-5D-5L (coefficient=0.07, p≤0.01), WPAI activity impairment (coefficient=-3.90, p≤0.01), ADAQ© (coefficient=-0.07, p≤0.01) , and the SF-12 mental health composite (coefficient=0.97, p=0.05).
Conclusion
These data demonstrate that CNI neurotoxicities significantly impact patient-reported outcomes, with fewer neurotoxicity side effects associated with better quality of life and treatment adherence, reduced activity impairment, and reduced physical and mental health burden.