Basiliximab: efficacy and safety evaluation in kidney transplantation

Ponticelli, Claudio

doi:10.1517/14740338.2014.861816

Cited by 22 publications

(18 citation statements)

References 71 publications

(30 reference statements)

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“…Novel therapies for AMR, possibly in addition to TPE and IVIG are now becoming available. These include newer medications such as anti‐CD20 for B cells (rituximab), proteasome inhibitors leading to plasma cell apoptosis (bortezomib), anti‐interleukin‐2 receptor antibodies (daclizumab, basiliximab), and anti‐CD52 (alemtuzumab). Anti‐complement therapy (eculizumab, recombinant human C1 esterase inhibitor) may also be possibilities in the future to interfere with the complement cascade initiated by antigen–antibody complexes, which has a potential to prevent complement‐mediated cell damage.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of plasmapheresis on donor‐specific antibody reduction by HLA specificity in post–kidney transplant recipients

et al. 2014

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BACKGROUND Donor-specific antibodies (DSAs) to HLA antigens can cause acute antibody-mediated rejection (AMR) after kidney transplantation (Txp). Therapeutic plasma exchange (TPE) has been used for AMR treatment; however, DSA reduction rates are inconsistent. We investigated DSA reduction rates by HLA specificity and clinical outcome. STUDY DESIGN AND METHODS Sixty-four courses of TPE for 56 kidney Txp recipients with high DSA were investigated. Dates of TPE procedures and Txp, patients’ age, sex, race, creatinine (Cr), and mean fluorescent intensity (MFI) of DSA were retrieved. MFI reduction rate after one to three TPE and four to six TPE procedures were calculated by HLA DSA specificity in each patient, and the mean reduction rates were compared. The relationship of TPE treatment, MFI or Cr improvement rate, and graft age was also investigated. RESULTS Patients received a mean 6.0 TPE procedures. Most received intravenous immunoglobulin after TPE and immunosuppressives. Forty-two cases (65.6%) had DSA to HLA Class I and 54 cases (84.4%) to Class II, including 32 cases (50.0%) to both. Mean MFI reduction rates after one to three TPE and four to six TPE procedures were 25.7 and 37.1% in HLA Class I, 25.1 and 34.2% in Class II, and 14.3 and 19.9% in DR51-53. The mean Cr improvements at the end of TPE and 3 and 6 months after TPE were 3.41, −0.37, and −0.72%, respectively. CONCLUSION Six TPE procedures decreased DSA more than three TPE procedures, but reduction rate was lower by the second three TPE procedures than the first three TPE procedures. Although the mean Cr improvement was minimal, the treatment has good potential to stop further deterioration of kidney function. Better Cr improvement rate is correlated with the graft age.

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Section: Discussionmentioning

confidence: 99%

Efficacy of plasmapheresis on donor‐specific antibody reduction by HLA specificity in post–kidney transplant recipients

et al. 2014

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“…There is, however, some evidence from registry data to suggest that the lower rejection rates might translate into better graft survival [121]. Pharmacoeconomic analysis has shown that these agents are cost effective in the early post-transplant period, and this is embodied in National Institute for Clinical Excellence (NICE) guidelines (https://www.nice.org.uk/guidance/ta85) [165]. …”

Section: Rationale For Clinical Practice Guidelines For Post-operativmentioning

confidence: 99%

Renal association clinical practice guideline in post-operative care in the kidney transplant recipient

et al. 2017

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These guidelines cover the care of patients from the period following kidney transplantation until the transplant is no longer working or the patient dies. During the early phase prevention of acute rejection and infection are the priority. After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection). The topics discussed include organization of outpatient follow up, immunosuppressive medication, treatment of acute and chronic rejection, and prevention of complications. The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders. There is also a section on contraception and reproductive issues.Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and AD depending on the quality of the evidence that the recommendation is based on.

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“…1,2 The use of the non-T-cell depleting agents [IL-2 receptor antagonist (IL-2 RA) preparations] is still popular choices within kidney transplantation, but is generally recommended for use in lower immunologic risk patients. 6–8 …”

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confidence: 99%

Cytolytic Induction Therapy Improves Clinical Outcomes in African-American Kidney Transplant Recipients

et al. 2017

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Objective Determine the impact of cytolytic versus IL-2 receptor antibody (IL-2RA) induction on acute rejection, graft loss and death in African-American (AA) kidney transplant (KTX) recipients. Background AAs are underrepresented in clinical trials in transplantation; thus, there is controversy regarding the optimal choice of perioperative antibody induction in KTX to improve outcomes. Methods National cohort study using US transplant registry data from January 1, 2000 to December 31, 2009 in adult solitary AA KTX recipients, with at least 5 years of follow-up. Multivariable logistic and Cox regression were utilized to assess the outcomes of acute rejection, graft loss, and mortality, with interaction terms to assess effect modification. Results Twenty-five thousand eighty-four adult AAs receiving solitary KTX were included, 16,927 (67.5%) received cytolytic induction and 8157 (32.5%) received IL-2RA induction. After adjustment for recipient sociodemographics, donor, and transplant characteristics, the use of cytolytic induction therapy reduced the risk of acute rejection by 32% (OR 0.68, 0.62–0.75), graft loss by 9% (HR 0.91, 0.86–0.97), and death by 12% (HR 0.88, 0.83–0.94). There were a number of significant effect modifiers, including public insurance, panel reactive antibody, delayed graft function, and steroid withdrawal; in these groups, cytolytic induction substantially improved clinical outcomes. Conclusions These data demonstrate that cytolytic induction therapy, as compared with IL-2RA, reduces the risk of rejection, graft loss, and death in adult AA KTX recipients, particularly in those who are sensitized, receive public insurance, develop delayed graft function, or undergo steroid withdrawal.

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Basiliximab: efficacy and safety evaluation in kidney transplantation

Cited by 22 publications

References 71 publications

Efficacy of plasmapheresis on donor‐specific antibody reduction by HLA specificity in post–kidney transplant recipients

Efficacy of plasmapheresis on donor‐specific antibody reduction by HLA specificity in post–kidney transplant recipients

Renal association clinical practice guideline in post-operative care in the kidney transplant recipient

Cytolytic Induction Therapy Improves Clinical Outcomes in African-American Kidney Transplant Recipients

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