Basiliximab lowers the cyclosporine therapeutic threshold in the early post‐kidney transplant period
Basiliximab lowers the cyclosporine therapeutic threshold in the early post‐kidney transplant period
复制标题
巴利昔单抗降低肾移植后早期环孢素治疗阈值
作者：
F. Balbontin;B. Kiberd;A. Fraser;M. Kiberd;J. Lawen
翻译后摘要：早期足够的环孢素暴露已被证明是预测低急性排斥反应率在肾移植。 本研究的目的是确定巴利昔单抗诱导超过早期环孢素治疗暴露阈值的重要性。对接受或未接受巴利昔单抗诱导、Neoral、吗替麦考酚酯和泼尼松治疗的166例首次尸体和非完全相同活体供体移植受者进行了回顾性分析。充分暴露定义为第3天新口服给药后2小时环孢菌素水平（C2）>1700 ng/mL。 主要结局是前6个月内的急性排斥反应。 在无巴利昔单抗（对照）组（n = 74）中，23%（17/74）的受者发生排斥反应，并与第3天的低环孢素暴露密切相关。 C2 <1700 ng/mL的患者发生急性排斥反应的比例为38%（11/29），而C2 ≥1700 ng/mL的患者发生急性排斥反应的比例为13%（6/45）（p = 0.014）。 在巴利昔单抗组（n = 92）中，仅11%（10/92）的受者发生排斥反应，与环孢素暴露无关。 C2 <1700 ng/mL的急性排斥发生率为10%（40例中的4例），而C2 ≥1700 ng/mL的急性排斥发生率为12%（52例中的6例）（p = 0.81）。 因此，当使用抗IL 2受体抗体诱导时，可能不需要在第3天达到环孢素治疗目标。
Abstract: Early adequate cyclosporine exposure has been shown to predict low acute rejection rate in kidney transplantation. The aim of this study is to determine the importance of exceeding the early cyclosporine therapeutic exposure threshold with basiliximab induction. A retrospective analysis of 166 first cadaveric and non‐identical live donor transplant recipients treated with or without basiliximab induction, Neoral, mycophenolate mofetil and prednisone, was performed. Adequate exposure was defined as a 2‐h post‐Neoral dose cyclosporine level (C2) >1700 ng/mL at day 3. The primary outcome was acute rejection within the first 6 months. In the no basiliximab (control) group (n = 74), rejection occurred in 23% (17 of 74) of recipients and was strongly associated with low cyclosporine exposure on day 3. Acute rejection occurred in 38% (11 of 29) with C2 <1700 ng/mL compared with 13% (six of 45) with C2 ≥1700 ng/mL (p = 0.014). In the basiliximab group (n = 92), rejection occurred in only 11% (10 of 92) of recipients and did not correlate with cyclosporine exposure. Acute rejection occurred in 10% (four of 40) with C2 <1700 ng/mL compared with 12% (six of 52) with C2 ≥1700 ng/mL (p = 0.81). Therefore achieving cyclosporine therapeutic targets by day 3 may not be required when anti‐IL2 receptor antibody induction is used.
影响因子：
6.2
作者：
J. KUPIEC-WEGLINSKI;Tibor Diamantstein;N. Tilney
通讯作者：
J. KUPIEC-WEGLINSKI;Tibor Diamantstein;N. Tilney