BACKGROUND: One-year results of a randomized, double-blinded trial of Thymoglobulin versus Atgam for induction therapy in renal transplantation revealed that Thymoglobulin was associated with higher event-free survival (94% vs. 63%), less acute rejection (4% vs. 25%), and better graft survival. This article compares the safety and efficacy of Thymoglobulin versus Atgam induction through 5 years. METHODS: Review and analysis of clinic records and electronic databases. RESULTS: At 5 years, event-free survival (73% vs. 33%, P<0.001), graft survival (77% vs. 55%, P=0.047), and freedom from rejection (92% vs. 66%, P=0.007) were higher with Thymoglobulin versus Atgam. No additional cytomegalovirus (CMV) disease occurred after the first year with Thymoglobulin or Atgam (13% vs. 33%, P=0.056). There were two cases of posttransplant lymphoproliferative disorder (PTLD) with the Atgam arm and none with Thymoglobulin. Thymoglobulin was associated with profound lymphopenia at 2 years after transplantation. CONCLUSIONS:Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam. The prolonged and profound lymphopenia may contribute to the long-term results associated with Thymoglobulin.
RCT Entities:
BACKGROUND: One-year results of a randomized, double-blinded trial of Thymoglobulin versus Atgam for induction therapy in renal transplantation revealed that Thymoglobulin was associated with higher event-free survival (94% vs. 63%), less acute rejection (4% vs. 25%), and better graft survival. This article compares the safety and efficacy of Thymoglobulin versus Atgam induction through 5 years. METHODS: Review and analysis of clinic records and electronic databases. RESULTS: At 5 years, event-free survival (73% vs. 33%, P<0.001), graft survival (77% vs. 55%, P=0.047), and freedom from rejection (92% vs. 66%, P=0.007) were higher with Thymoglobulin versus Atgam. No additional cytomegalovirus (CMV) disease occurred after the first year with Thymoglobulin or Atgam (13% vs. 33%, P=0.056). There were two cases of posttransplant lymphoproliferative disorder (PTLD) with the Atgam arm and none with Thymoglobulin. Thymoglobulin was associated with profound lymphopenia at 2 years after transplantation. CONCLUSIONS: Thymoglobulin was associated with higher event-free survival, graft survival, and freedom from rejection without increased PTLD or CMV disease at 5 years compared with Atgam. The prolonged and profound lymphopenia may contribute to the long-term results associated with Thymoglobulin.
Authors: Xingmin Feng; Sachiko Kajigaya; Elena E Solomou; Keyvan Keyvanfar; Xiuli Xu; Nalini Raghavachari; Peter J Munson; Thomas M Herndon; Jichun Chen; Neal S Young Journal: Blood Date: 2008-02-04 Impact factor: 22.113
Authors: L Cherkassky; M Lanning; P N Lalli; J Czerr; H Siegel; L Danziger-Isakov; T Srinivas; A Valujskikh; D A Shoskes; W Baldwin; R L Fairchild; E D Poggio Journal: Am J Transplant Date: 2011-05-12 Impact factor: 8.086
Authors: Karen L Hardinger; Sunny Rhee; Paula Buchanan; Matt Koch; Brent Miller; Decha Enkvetchakul; Rebecca Schuessler; Mark A Schnitzler; Daniel C Brennan Journal: Transplantation Date: 2008-10-15 Impact factor: 4.939