Literature DB >> 19424032

A randomized, doubleblind, placebo-controlled, study of single-dose rituximab as induction in renal transplantation.

Gunnar Tydén1, Helena Genberg, Jan Tollemar, Henrik Ekberg, Nils H Persson, Gunnar Tufveson, Jonas Wadström, Markus Gäbel, Lars Mjörnstedt.   

Abstract

UNLABELLED: We performed a prospective, double blind, randomized, placebo-controlled multicenter study on the efficacy and safety of rituximab as induction therapy, together with tacrolimus, mycophenolate mofetil, and steroids. The primary endpoint was defined as acute rejection, graft loss, or death during the first 6 months. Secondary endpoints were creatinine clearance, incidence of infections, and incidence of rituximab-related adverse event.
RESULTS: We enrolled 140 patients (44 living donor and 96 deceased donor), and of those, 68 rituximab and 68 placebo patients fulfilled the study. In all the patients receiving rituximab, there was a complete depletion of CD19/CD20 cells, whereas there was no change in the number of CD19/CD20 cells in the placebo group. There were 10 treatment failures in the rituximab group versus 14 in the placebo group (P=0.348). There were eight rejection episodes in the rituximab group versus 12 in the placebo group (P=0.317) Creatinine clearance was 66+/-22 mL/min in the study group and 67+/-23 mL/min in the placebo group. There was no difference in the number of bacterial infections, cytomegalovirus infections, and BK virus infections or fungal infections.
CONCLUSION: We performed a placebo-controlled study of rituximab induction in renal transplantation. There was a tendency toward fewer and milder rejections during the first 6 months in the rituximab group. Although induction with one dose of rituximab induced a complete depletion B cells, there was no increase in the incidence of infectious complications or leukopenia and it seems safe, therefore, to conduct further studies on the use of rituximab in transplantation.

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Year:  2009        PMID: 19424032     DOI: 10.1097/TP.0b013e3181a235fd

Source DB:  PubMed          Journal:  Transplantation        ISSN: 0041-1337            Impact factor:   4.939


  38 in total

Review 1.  Antibody immunosuppressive therapy in solid organ transplant: Part II.

Authors:  Dusko Klipa; Nadim Mahmud; Nasimul Ahsan
Journal:  MAbs       Date:  2010-11-01       Impact factor: 5.857

Review 2.  Effector mechanisms of rejection.

Authors:  Aurélie Moreau; Emilie Varey; Ignacio Anegon; Maria-Cristina Cuturi
Journal:  Cold Spring Harb Perspect Med       Date:  2013-11-01       Impact factor: 6.915

3.  CD4 T Cell Help via B Cells Is Required for Lymphopenia-Induced CD8 T Cell Proliferation.

Authors:  Katayoun Ayasoufi; Ran Fan; Robert L Fairchild; Anna Valujskikh
Journal:  J Immunol       Date:  2016-02-24       Impact factor: 5.422

4.  Antibody induction therapy in adult kidney transplantation: A controversy continues.

Authors:  Kanwaljit K Chouhan; Rubin Zhang
Journal:  World J Transplant       Date:  2012-04-24

5.  B cell modulation in transplantation.

Authors:  M R Clatworthy
Journal:  Clin Exp Immunol       Date:  2014-12       Impact factor: 4.330

Review 6.  Rituximab in immunologic glomerular diseases.

Authors:  A Ahsan Ejaz; Abdo Asmar; Mourad M Alsabbagh; Nasimul Ahsan
Journal:  MAbs       Date:  2012-03-01       Impact factor: 5.857

Review 7.  Essential role for B cells in transplantation tolerance.

Authors:  Robert R Redfield; Eduardo Rodriguez; Ronald Parsons; Kumar Vivek; Moiz M Mustafa; Hooman Noorchashm; Ali Naji
Journal:  Curr Opin Immunol       Date:  2011-10       Impact factor: 7.486

Review 8.  Strategies to overcome the ABO barrier in kidney transplantation.

Authors:  Georg A Böhmig; Andreas M Farkas; Farsad Eskandary; Thomas Wekerle
Journal:  Nat Rev Nephrol       Date:  2015-09-01       Impact factor: 28.314

Review 9.  The paradoxical functions of B cells and antibodies in transplantation.

Authors:  Marilia I Cascalho; Brian J Chen; Mandy Kain; Jeffrey L Platt
Journal:  J Immunol       Date:  2013-02-01       Impact factor: 5.422

10.  Preemptive CD20+ B cell Depletion Attenuates Cardiac Allograft Vasculopathy in CD154-Treated Monkeys.

Authors:  Agnes M Azimzadeh; Tianshu Zhang; Guosheng Wu; Shahrooz S Kelishadi; Tiffany Stoddard; Natalie OʼNeill; Bao-Ngoc Nguyen; Emily Welty; Christopher Avon; Mitch Higuchi; Stuart L Mitchell; Alena Hershfeld; Xiang-Fei Cheng; Anthony Kronfli; Elana Rybak; Lars Burdorf; Richard N Pierson
Journal:  Transplantation       Date:  2017-01       Impact factor: 4.939

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