Comparison of alemtuzumab and anti-thymocyte globulin treatment for acute kidney allograft rejection
| Autor: | Marieke van der Zwan, Marian C. Clahsen-Van Groningen, Martijn W. F. van den Hoogen, Marcia M. L. Kho, Joke I. Roodnat, Katya A. L. Mauff, Dave L. Roelen, Madelon van Agteren, Carla C. Baan, Dennis A. Hesselink |
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| Přispěvatelé: | Internal Medicine, Pathology, Epidemiology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult Graft Rejection Male lcsh:Immunologic diseases. Allergy medicine.medical_specialty Immunology kidney transplantation Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine alemtuzumab Immunology and Allergy Humans Adverse effect Kidney transplantation Original Research Antilymphocyte Serum Retrospective Studies Transplantation Kidney business.industry allograft rejection Hazard ratio Middle Aged medicine.disease Allografts Anti-thymocyte globulin 030104 developmental biology medicine.anatomical_structure rabbit anti-thymocyte globulin Allograft rejection Propensity score matching Alemtuzumab Female lcsh:RC581-607 business T cell depletion Immunosuppressive Agents Kidney transplant rejection 030215 immunology medicine.drug |
| Zdroj: | Frontiers in Immunology, 11:1332. Frontiers Media S.A. Frontiers in Immunology, Vol 11 (2020) Frontiers in Immunology, 11. FRONTIERS MEDIA SA Frontiers in Immunology |
| ISSN: | 1664-3224 |
| Popis: | Rabbit anti-thymocyte globulin (rATG) is currently the treatment of choice for glucocorticoid-resistant, recurrent, or severe acute allograft rejection (AR). However, rATG is associated with severe infusion-related side effects. Alemtuzumab is incidentally given to kidney transplant recipients as treatment for AR. In the current study, the outcomes of patients treated with alemtuzumab for AR were compared with that of patients treated with rATG for AR. The patient-, allograft-, and infection-free survival and adverse events of 116 alemtuzumab-treated patients were compared with those of 108 patients treated with rATG for AR. Propensity scores were used to control for differences between the two groups. Patient- and allograft survival of patients treated with either alemtuzumab or rATG were not different [hazard ratio (HR) 1.14, 95%-confidence interval (CI) 0.48–2.69, p = 0.77, and HR 0.82, 95%-CI 0.45–1.5, p = 0.52, respectively). Infection-free survival after alemtuzumab treatment was superior compared with that of rATG-treated patients (HR 0.41, 95%-CI 0.25–0.68, p < 0.002). Infusion-related adverse events occurred less frequently after alemtuzumab treatment. Alemtuzumab therapy may therefore be an alternative therapy for glucocorticoid-resistant, recurrent, or severe acute kidney transplant rejection. |
| Databáze: | OpenAIRE |
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