Drug therapy reduces risk of rejection in kidney transplant patients

Treatment with anti-thymocyte globulin (rabbit [Thymoglobulin]) results in a significantly reduced risk of acute rejection and acute rejection requiring antibody therapy and a similar risk of delayed graft function, graft loss, and death in kidney transplant patients compared with patients receiving induction therapy with basiliximab (Simulect), according to a study published this month in the New England Journal of Medicine (2006; 355:1967-77).

The study involved 278 patients at high risk for acute rejection or delayed graft function following a kidney transplant from a deceased donor. At 12 months, the incidence of a composite endpoint (first occurrence of acute rejection, delayed graft function, graft loss, and death) was similar in the two groups (50.4% for the anti-thymocyte globulin group vs. 56.2% for the basiliximab group, p=.34).

The anti-thymocyte globulin group had a 38.8% lower incidence of acute rejection compared with the basiliximab group (15.6% vs. 25.5%, p=.02) and an 82.5% lower incidence of severe acute rejection requiring treatment with antibody (1.4% vs. 8%, p=.005).

“Our study showed the risk of acute rejection was about 1.5 times higher among patients treated with basiliximab, and the need for antibody treatment related to acute rejection was six times higher among the basiliximab group,” said first author Daniel C. Brennan, MD, of Washington University School of Medicine, St. Louis. “These results are an important contribution to our understanding of these treatment approaches, and we look forward to examining the longer-term outcomes of these patients.”

The study was supported by SangStat Medical Corp. and Genzyme.