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A systematic review in 2025 identified one qualifying clinical study: a retrospective analysis in which 7 of 12 subjects with chronic knee pain reported relief for over six months following intra-articular injection

Biosci Rep (2019) 39(12):BSR20192009

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In a review from Chandra et al., the author suggests to stay in the target trough level, albeit risking over-immunosuppression, and only reduce Tac dose if nephrotoxicity is suspected (113)

Moustafa K, Abu QS, Jarrar M et al (2014) MAPK cascades and major abiotic stresses

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