Multicenter randomized prospective trial of steroid withdrawal in renal transplant recipients receiving basiliximab, cyclosporine microemulsion and mycophenolate mofetil

被引:112
作者
Vincenti, F [1 ]
Monaco, A
Grinyo, J
Kinkhabwala, M
Roza, A
机构
[1] Univ Calif San Francisco, San Francisco, CA 94143 USA
[2] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[3] Bellvitge Hosp, Barcelona, Spain
[4] New York Hosp, New York, NY 10021 USA
[5] Froedtert Mem Lutheran Hosp, Milwaukee, WI USA
关键词
basiliximab; kidney transplantation; steroids;
D O I
10.1034/j.1600-6143.2003.00005.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Corticosteroids withdrawal from immunosuppressive regimens has thus far been associated with increased risk of acute rejection episodes. In this study, basiliximab, a chimeric monoclonal interleukin-2 receptor antagonist, added to a maintenance regimen consisting of cyclosporine microemulsion and mycophenolate mofetil was studied for its effectiveness in allowing early corticosteroid withdrawal in de novo renal allograft recipients. Primary renal transplant recipients receiving basiliximab, cyclosporine-microemulsion, and mycophenolate mofetil, were randomized to either corticosteroid withdrawal at day four post-transplantation (n = 40) or standard steroid therapy (n = 43). The primary endpoint was the incidence of biopsy-proven acute rejection episodes. Randomized subjects who underwent transplantation and received at least one dose of basiliximab were analyzed in an intent-to-treat fashion. The incidence of biopsy-proven acute rejection at 12 months was not significantly different between the steroid withdrawal group (20%) and the standard treatment group (16%). Patient and graft survival was 100% in the steroid withdrawal group while one death in a patient with a functioning graft occurred in the standard steroid group. Seventy-two percent of the steroid withdrawal group remained off steroids at 6 months post-transplant. Allograft function and incidence of adverse events and infections were similar between the two groups. Rapid and early corticosteroid withdrawal among renal transplant recipients receiving basiliximab induction and daily therapy with cyclosporine-microemulsion and mycophenolate mofetil was not associated with an increased risk of acute rejection.
引用
收藏
页码:306 / 311
页数:6
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