Limited-Dose Daclizumab Versus Basiliximab: A Comparison of Cost and Efficacy in Preventing Acute Rejection

• Published in: Transplantation proceedings Vol. 37; no. 2; pp. 899 - 902
• Main Authors: Pham, K., Kraft, K., Thielke, J., Oberholzer, J., Sankary, H., Testa, G., Benedetti, E.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2005; Elsevier Science
• Subjects: Adult; Antibodies, Monoclonal - economics; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Continental Population Groups; Costs and Cost Analysis; Creatinine - blood; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - prevention & control; Humans; Immunoglobulin G - economics; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - economics; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - immunology; Male; Medical sciences; Middle Aged; Recombinant Fusion Proteins - economics; Recombinant Fusion Proteins - therapeutic use; Reproducibility of Results; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Graft(material); Acute; Transplantation; Monoclonal antibody; Daclizumab; Immunomodulator; Medicine; Prevention; Rejection; Limit dose; Treatment; Surgery; Basiliximab; Health economy; Immunotherapy; Anticytokine; Graft; Immunosuppressive agent; Public health; Comparative study; Cost efficiency analysis
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.12.079

The purpose of this study was to compare the efficacy and cost of the limited-dose Daclizumab regimen to that of the standard-dose Basiliximab regimen. Two antibody induction regimens were compared in patients aged 18 years and older who received renal transplants from January 2002 to September 2003 and completed interleukin (IL)-2R antibody induction with standard-dose Basiliximab (20 mg × 2 doses) or limited-dose Daclizumab (1 mg/kg × 2 doses). The primary outcome measure was the incidence of acute rejection. Secondary outcomes included cost, changes in serum creatinine level, and delayed graft function. Of the 46 patients randomized, 42 patients completed the 6-month follow-up. Mean serum creatinine level at time of discharge was originally higher in the limited-dose Daclizumab group than the standard-dose Basiliximab group (1.89 vs 1.57, respectively). By 1, 3, and 6 months, mean serum creatinine values were similar between both groups, with a trend toward lower mean serum creatinine values in the limited-dose Daclizumab group. The incidence of acute rejection was also similar between the groups (6% vs 7%). The average cost difference between the 2 regimens was approximately $715. This study suggests that a limited-dose Daclizumab regimen may be an efficacious and less costly alternative to the standard-dose Basiliximab regimen for antibody induction therapy following renal transplantation.