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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)

230 This modification can improve the resistance of nucleic acids to nucleases, enhance blood stability, reduce renal clearance, and prolong the circulation time of drugs in vivo by improving their binding to plasma proteins

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Biosci Rep (2019) 39(12):BSR20192009

Collectively, these studies indicate that these molecules constitute complex autocrine/paracrine networks to regulate cell proliferation, survival, and differentiation, controlling the pace of cartilage and bone development and remodeling

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