RESULTS OF THE DOUBLE-BLIND, RANDOMIZED, MULTICENTER, PHASE III CLINICAL TRIAL OF THYMOGLOBULIN VERSUS ATGAM IN THE TREATMENT OF ACUTE GRAFT REJECTION EPISODES AFTER RENAL TRANSPLANTATION1,2
| Autor: | E. C. Squiers, Rodney J. Taylor, Ernest E. Hodge, Jimmy A. Light, Fuad S. Shihab, Kathleen R. Lamborn, Laura L. Mulloy, John F. Neylan, Douglas J. Norman, Raymond J. Tesi, M. Roy First, Robert Mendez, Laurence Chan, Hana Berger Moran, Lawrence Kahana, Stuart J. Knechtle, H. Rossiter Horn, Steven M. Steinberg, Robert S. Gaston, Giacomo Basadonna, Robert J. Stratta, Robert W. Steiner, Osama Gaber, E. Steve Woodle, Daniel C. Brennan, John M. Ham, Lillian W. Gaber, Barry D. Kahan, Timothy J. Schroeder, Erik Wahlstrom, Philippe Pouletty |
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| Rok vydání: | 1998 |
| Předmět: |
Transplantation
Chemotherapy medicine.medical_specialty Creatinine Thymoglobulin business.industry medicine.medical_treatment Urology medicine.disease law.invention Surgery chemistry.chemical_compound Randomized controlled trial chemistry law Clinical endpoint medicine Complication business Kidney transplantation |
| Zdroj: | Transplantation. 66:29-37 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/00007890-199807150-00005 |
| Popis: | Background. Thymoglobulin, a rabbit anti-human thymocyte globulin, was compared with Atgam, a horse anti-human thymocyte globulin for the treatment of acute rejection after renal transplantation. Methods. A multicenter, double-blind, randomized trial with enrollment stratification based on standardized histology (Banff grading) was conducted. Subjects received 7-14 days of Thymoglobulin (1.5 mg/kg/ day) or Atgam (15 mg/kg/day). The primary end point was rejection reversal (return of serum creatinine level to or below the day 0 baseline value). Results. A total of 163 patients were enrolled at 25 transplant centers in the United States. No differences in demographics or transplant characteristics were noted. Intent-to-treat analysis demonstrated that Thymoglobulin had a higher rejection reversal rate than Atgam (88% versus 76%, P=0.027, primary end point). Day 30 graft survival rates (Thymoglobulin 94% and Atgam 90%, P=0.17), day 30 serum creatinine levels as a percentage of baseline (Thymoglobulin 72% and Atgam 80%; P=0.43), and improvement in posttreatment biopsy results (Thymoglobulin 65% and Atgam 50%; P=0.15) were not statistically different. T-cell depletion was maintained more effectively with Thymoglobulin than Atgam both at the end of therapy (P=0.001) and at day 30 (P=0.016). Recurrent rejection, at 90 days after therapy, occurred less frequently with Thymoglobulin (17%) versus Atgam (36%) (P=0.011). |
| Databáze: | OpenAIRE |
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