Basiliximab Improves Graft Survival in Renal Transplant Recipients With Delayed Graft Function

Gonçalves, Luiz Felipe Santos; Ribeiro, Alexandre Moretto; Berdichevski, Roberto Herz; Joelsons, Gabriel; Proença, Maria Conceição da Costa; Manfro, Roberto Ceratti

doi:10.1016/j.transproceed.2007.01.041

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Compared with the steroid control, basiliximab induction demonstrated a lower incidence of steroid-resistant AR (20.9% vs. 6%, p = 0.017) and AMR (7% vs. 0%, p = 0.038) at 1 year. The 1-year graft survival was significantly higher in basiliximab group than the control group (92.8% vs. 80.4%, p = 0.028) [14]. To our knowledge, this was the only study published by others to compare induction therapies in patients with DGF.…”

Section: Discussionmentioning

confidence: 64%

“…In literature, Goncalves LF, et al reported a shortterm study of 148 Brazilians with DGF: 90 of them received basiliximab induction and remaining 58 patients received steroid induction as the control group [14]. Both groups were maintained with triple combination of steroid, CNI and MMF.…”

Section: Discussionmentioning

confidence: 99%

“…Successful prevention and/or treatment of AR can decrease the risk of graft loss. However, the ideal immunosuppressive regimen for patients with DGF has not been established and the selection of the optimal induction agent remains speculative [11][12][13][14][15][16][17][18][19]. Current induction agents include methylprednisolone, interleukin-2 receptor (IR2R) antibody (basiliximab) and lymphocyte-depleting antibody (antithymocyte globulin and alemtuzumab).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcomes of Induction Therapies with Alemtuzumab, Basiliximab or Methylprednisolone in Kidney Transplant Patients with Delayed Graft Function

Zhang¹,

Beatrice²,

Liu³

et al. 2018

J Transplant Surg

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Introduction: Delayed graft function (DGF) after kidney transplant is associated with high risk of acute rejection (AR) and graft failure. The optimal immunosuppressive strategy for patients with DGF remains unknown. Material and method:We compare the 5-year outcomes of induction therapies with methylprednisolone (n = 58), basiliximab (n = 56) or alemtuzumab (n = 98) in patients with DGF. Maintenance was tacrolimus and mycophenolate with prednisone in methylprednisolone and basiliximab groups or without prednisone in alemtuzumab group. Protocol biopsies were performed in all patients.Results: 5-year biopsy-confirmed AR rates were significantly different among the 3 groups (39.7%, 28.6% and 20.4% in methylprednisolone, basiliximab and alemtuzumab group, respectively; p = 0.034). There was a trend of difference in Kaplan-Meier estimated 5-year graft survivals among the 3 groups (65.5%, 71.4% and 80.6%, respectively; log rank p = 0.07). Alemtuzumab group had a lowest incidence of AR and highest graft survival. The 5-year patient survivals were not statistically different in the 3 groups (75.9%, 82.1% and 84.7%, log rank p = 0.4). Multivariable analysis using methylprednisolone induction as control indicated that alemtuzumab (HR 0.36, 95% CI 0.13-0.85; p = 0.036) and basiliximab (HR 0.67, 95% CI 0.20-0.97; p = 0.023) were associated with lower risk of AR. Conclusion:Alemtuzumab induction decreases AR rate in kidney transplant patients with DGF and can improve longterm graft survival in comparison to other induction therapies.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcomes of Induction Therapies with Alemtuzumab, Basiliximab or Methylprednisolone in Kidney Transplant Patients with Delayed Graft Function

Zhang¹,

Beatrice²,

Liu³

et al. 2018

J Transplant Surg

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“…[60][61][62] For example, during 4 years of follow-up in the largest (n = 253) of these analyses, [62] patients who had received basiliximab combined with triple immunotherapy had a significantly lower acute rejection rate (7.6% vs 24%; p £ 0.001). [63] However, in another analysis of high-risk patients (n = 112), the addition of basiliximab to tacrolimus-based immunosuppression did not significantly improve outcomes further than immunosuppressive therapy alone, with respect to reducing acute rejections, or improving renal function or graft survival. [62] In an analysis that evaluated only high-risk patients (n = 148), the addition of basiliximab to triple immunotherapy improved outcomes in patients with DGF compared with immunotherapy without basiliximab.…”

Section: Long-term Follow-upmentioning

confidence: 92%

Basiliximab

McKeage

McCormack²

2010

BioDrugs

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Basiliximab (Simulect) is a recombinant chimeric murine/human IgG1 monoclonal anti-interleukin-2 receptor antibody that is indicated for the prevention of acute organ rejection in adult and pediatric renal transplant recipients in combination with other immunosuppressive agents. Induction therapy with two doses (day 0 and day 4) of intravenous basiliximab as part of double- or triple-immunotherapy regimens in adult renal transplant recipients reduces acute rejection episodes without increasing the incidence of adverse events. Compared with rabbit-derived antithymocyte globulin (RATG), basiliximab is generally associated with similar efficacy in standard-risk patients, but reduced efficacy in high-risk patients. Initial results indicate that induction with basiliximab is associated with a higher rate of biopsy-proven acute rejection than alemtuzumab induction. Basiliximab is generally associated with a tolerability profile that is similar to that reported with placebo, and better than that reported with RATG. As with other induction agents, basiliximab has not demonstrated improved graft or patient survival over the long term (periods of up to 7 years). Basiliximab induction allows for reduced dosage of corticosteroids or calcineurin inhibitors, while maintaining adequate immunosuppression, thereby reducing the potential for adverse effects associated with these coadministered agents. Thus, basiliximab provides an effective, well tolerated option for the prophylaxis of acute renal transplant rejection.

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Monoclonal Antibodies as Therapeutic Agents

Khan

2008

Immunopharmacology

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Basiliximab Improves Graft Survival in Renal Transplant Recipients With Delayed Graft Function

Cited by 6 publications

References 8 publications

Long-Term Outcomes of Induction Therapies with Alemtuzumab, Basiliximab or Methylprednisolone in Kidney Transplant Patients with Delayed Graft Function

Long-Term Outcomes of Induction Therapies with Alemtuzumab, Basiliximab or Methylprednisolone in Kidney Transplant Patients with Delayed Graft Function

Basiliximab

Monoclonal Antibodies as Therapeutic Agents

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