Induction therapy of basiliximab versus antithymocyte globulin in renal allograft: a systematic review and meta-analysis
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The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft.
Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4.1 software were used for the meta-analysis.
Eight RCTs were included, including a total of 1153 patients. Of these, 547 (47%) had received basiliximab, and 606 (53%) had received ATG. The pooled results revealed that the basiliximab had a lower rate of neoplasm compared with ATG [odds ratio (OR) 0.26; 95% confidence interval (CI) 0.08–0.78; P = 0.02]. There were no significant differences between the two drugs regarding 1-year acute rejection rate (OR 1.32; 95% CI 0.93–1.87; P = 0.13), 1-year graft survival rate (OR 0.73; 95% CI 0.45–1.18; P = 0.20), 1-year patient survival rate (OR 0.52; 95% CI 0.27–1.02; P = 0.06), 1-year infection rate (OR 0.90; 95% CI 0.48–1.68; P = 0.73).
Induction therapy of basiliximab has similar short-time effects on the recipients in renal transplantation compared with that of ATG. However, regarding the long-term effect, as represented by the rate of neoplasm, basiliximab has a significant advantage.
KeywordsBasiliximab ATG Renal allograft Meta
Compliance with ethical standards
Conflict of interest
The authors have declared that no conflict of interest exists.
Human and animal rights statement
This article does not contain any studies with human participants performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 3.Nashan B. Antibody induction therapy in renal transplant patients receiving calcineurin-inhibitor immunosuppressive regimens: a comparative review. BioDrugs Clin Immunother Biopharm Gene Ther. 2005;19(1):39.Google Scholar
- 5.Bouvy AP, Klepper M, Kho MM, Boer K, Betjes MG, Weimar W, et al. The impact of induction therapy on the homeostasis and function of regulatory T cells in kidney transplant patients. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 2014;29(8):1587.Google Scholar
- 6.Todeschini M, Cortinovis M, Perico N, Poli F, Innocente A, Cavinato RA, et al. In kidney transplant patients, alemtuzumab but not basiliximab/low-dose rabbit anti-thymocyte globulin induces B cell depletion and regeneration, which associates with a high incidence of de novo donor-specific anti-HLA antibody development. J Immunol. 2013;191(5):2818.CrossRefPubMedGoogle Scholar
- 16.Tuuminen R, Nykanen AI, Saharinen P, Gautam P, Keranen MA, Arnaudova R, et al. Donor simvastatin treatment prevents ischemia-reperfusion and acute kidney injury by preserving microvascular barrier function. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg. 2013;13(8):2019.CrossRefGoogle Scholar
- 17.Horowitz N, Oren I, Lavi N, Zuckerman T, Benyamini N, Kra-Oz Z, et al. New rising infection: human herpesvirus 6 is frequent in myeloma patients undergoing autologous stem cell transplantation after induction therapy with bortezomib. Bone Marrow Res. 2012;2012:409765.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Harzallah K, Abderrahim E, Chareffedine K, Yeich S, Belhadj R, Skhiri H, et al. Cancers after renal transplantation: multicenter experience. Saudi J Kidney Dis Transplant Off Publ Saudi Cent Organ Transplant Saudi Arab. 2008;19(5):825.Google Scholar
- 23.Al Najjar A, Etienne I, Le Pogamp P, Bridoux F, Le Meur Y, Toupance O, et al. Long-term results of monoclonal anti-Il2-receptor antibody versus polyclonal antilymphocyte antibodies as induction therapy in renal transplantation. Transplant Proc. 2006;38(7):2298.Google Scholar
- 24.Tullius SG, Pratschke J, Strobelt V, Kahl A, Reinke P, May G, et al. ATG versus basiliximab induction therapy in renal allograft recipients receiving a dual immunosuppressive regimen: one-year results. Transplant Proc. 2003;35(6):2100.Google Scholar
- 25.Pilch NA, Taber DJ, Moussa O, Thomas B, Denmark S, Meadows HB, et al. Prospective randomized controlled trial of rabbit antithymocyte globulin compared with IL-2 receptor antagonist induction therapy in kidney transplantation. Ann Surg. 2014;259(5):888.Google Scholar
- 26.Sollinger H, Kaplan B, Pescovitz MD, Philosophe B, Roza A, Brayman K, et al. Basiliximab versus antithymocyte globulin for prevention of acute renal allograft rejection. Transplantation. 2001;72(12):1915.Google Scholar
- 27.Kyllonen LE, Eklund BH, Pesonen EJ, Salmela KT. Single bolus antithymocyte globulin versus basiliximab induction in kidney transplantation with cyclosporine triple immunosuppression: efficacy and safety. Transplantation. 2007;84(1):75.Google Scholar
- 28.Brennan DC, Daller JA, Lake KD, Cibrik D, Del Castillo D, Thymoglobulin Induction Study G. Rabbit antithymocyte globulin versus basiliximab in renal transplantation. N Engl J Med. 2006;355(19):1967.Google Scholar
- 29.Patel HV, Kute VB, Vanikar AV, Shah PR, Gumber MR, Engineer DP, et al. Low-dose rabbit anti-thymoglobin globulin versus basiliximab for induction therapy in kidney transplantation. Saudi J Kidney Dis Transpl. 2014;25(4):819.Google Scholar