Analyze the selection and combination use of immunosuppressants in outpatient renal transplant recipients.

Retrospective analysis of outpatient prescription data for kidney transplantation in 105 medical institutions among 9 cities across China from January 2017 to December 2022. Information such as gender, age, number of visits, type of immunosuppressants, and combination of immunosuppressants were extracted from prescriptions containing immunosuppressants under kidney transplantation diagnosis.

A total of 161 989 prescriptions were obtained for 367 526 people. In the prescribing of immunosuppressants for outpatient patients after kidney transplantation, mycophenolic acids were the most frequently prescribed (125 824, 77.67%), followed by tacrolimus (97 979, 60.48%) and steroids (72 776, 44.93%). In the combination therapy, the use rate of tacrolimus+ mycophenolic acid+ steroids triple immunosuppressive regimen (18.87%-27.98%) and tacrolimus+ mycophenolic acid double immunosuppressive regimen (23.14%-27.16%) was relatively high. From the perspective of annual trends, the number of prescriptions for cyclosporine showed a decreasing trend year by year (24.75%-13.28%, R²=0.970 8), while the number of prescriptions for imidacloprid showed an increasing trend year by year (1.33%-2.67%, R²=0.956 6). Both the lack of CNI scheme and the issuance of sirolimus had the highest number of cases in 2022. The number of people who received hormone free treatment was the highest in 2017 (14 813, 61.09%), but decreased to the lowest in 2020 (12 309, 49.78%), and then began to rise again.

Tacrolimus dominates the use of calcineurin inhibitors after kidney transplantation, while mycophenolic acids are the main choice of antiproliferative drugs. The immunosuppressive regimen of tacrolimus+ mycophenolic acids+ steroids and tacrolimus+ mycophenolic is the main immunosuppressive maintenance regimen after kidney transplantation.