The Efficacy and Safety of Alemtuzumab and Daclizumab Versus Antithymocyte Globulin During Organ Transplantation: A Meta-Analysis

• Published in: Transplantation proceedings Vol. 44; no. 10; pp. 2955 - 2960
• Main Authors: Hao, W.-J, Zong, H.-T, Cui, Y.-S, Zhang, Y
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.12.2012; Elsevier
• Subjects: Acute Disease; Alemtuzumab; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antilymphocyte Serum - adverse effects; Antilymphocyte Serum - therapeutic use; Biological and medical sciences; Communicable Diseases - immunology; Drug Therapy, Combination; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - immunology; Graft Rejection - mortality; Graft Rejection - prevention & control; Graft Survival - drug effects; Humans; Immunoglobulin G - adverse effects; Immunoglobulin G - therapeutic use; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - adverse effects; Kidney Transplantation - immunology; Kidney Transplantation - mortality; Medical sciences; Odds Ratio; Pancreas Transplantation - adverse effects; Pancreas Transplantation - immunology; Pancreas Transplantation - mortality; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Transplantation Tolerance - drug effects; Treatment Outcome; Antineoplastic agent; Toxicity; Treatment efficiency; Transplantation; Alemtuzumab; Monoclonal antibody; Homotransplantation; Metaanalysis; Daclizumab; Immunomodulator; Medicine; Treatment; Surgery; Immunotherapy; Complication; Graft; Immunosuppressive agent; Safety; Antithymocyte globulin; Comparative study; Organ
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.05.085

Abstract Objective The objective of this study was to compare efficacy and safety of alemtuzumab, antithymocyte globulin (ATG), and daclizumab for induction therapy in organ transplantation. Methods We searched PUBMED, EMBASE, and Cochrane databases to identify randomized controlled trials that compared alemtzumab, ATG, and daclizumab for induction therapy in kidney as well as pancreas transplantation. According to the inclusion criteria, the collected data included general characteristics of the studies and their major outcomes. The meta-analysis was performed using RevMan 5.0.25 software. Results We identified 9 studies involving 777 patients. No differences between alemtuzumab, daclizumab, and ATG were observed in terms of patient survival, graft survival, or acute rejection episodes at a 24-month follow-up ( P = .62, P = .55, and P = .08, respectively). Infections within 36 months were greater between the alemtuzumab and the ATG group ( P = .03). There was no significant difference in terms of infection at 24 months. Conclusions Alemtuzumab and daclizumab appeared to be as effective as ATG for induction therapy in kidney transplantation at a follow-up of 24 months. However, alemtuzumab showed a lower rate of infection at 36 months compared with ATG.