Background: About half of the transplantation centers use induction therapy after heart transplantation. Interleukin-2 receptor antagonists (IL-2Ras) are used increasingly for induction therapy. We conducted a systematic review of randomized trials assessing IL-2Ras.
Methods: We searched CENTRAL, PubMed, EMBASE and Web of Science up to November 2007 for randomized trials comparing IL-2Ra vs placebo/no treatment or another antibody induction therapy. Data were extracted and quality was assessed independently by two investigators. Outcome measures were mortality, biopsy-proven acute rejection (Grade > or =3A), infections and malignancy. Data were presented as the relative risk (RR) with 95% confidence interval (CI).
Results: We found 9 randomized trials evaluating IL-2Ra as induction therapy after heart transplantation. All were high-bias risk trials. Four trials compared IL-2Ra with placebo/no treatment, 3 trials compared IL-2Ra with polyclonal antibody and 2 trials compared IL-2Ra with monoclonal antibody. Follow-up ranged from 6 to 12 months, except for 2 trials with up to 10 years of follow-up. When IL-2Ra vs placebo/no treatment was meta-analyzed with a fixed-effect model, IL-2Ra significantly reduced the risk of acute rejection (RR 0.73, 95% CI 0.59 to 0.90), but not according to a random-effects model (RR 0.73, 95% CI 0.46 to 1.17). IL-2Ra significantly increased acute rejection when compared with polyclonal antibody (RR 2.99, 95% CI 1.42 to 6.28), but not when compared with monoclonal antibody (RR 0.94, 95% CI 0.74 to 1.20). No significant differences were found regarding mortality, infections or malignancy.
Conclusions: Evidence for the use of induction therapy after heart transplantation is sparse. This systematic review found no convincing evidence of a survival benefit or reduction in cardiac allograft rejection. Thus, the routine use of IL-2Ra in cardiac transplantation remains unsupported.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.healun.2008.05.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multimodal Therapy May be Key to Improving Survival for Octogenarians Undergoing Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: An American Multicenter Analysis.
Ann Surg Oncol
January 2025
Department of Surgery, NorthShore University Health System, Evanston, IL, USA.
Background: As the population ages, the number of octogenarians with pancreatic ductal adenocarcinoma (PDAC) continues to rise. Morbidity and mortality following pancreatectomy have improved owing to safer surgery and better chemoradiation regimens. This study compares the outcomes and multimodality utilization in octogenarians (≥80 years) who underwent pancreaticoduodenectomy (PD) for PDAC, with a younger cohort.
View Article and Find Full Text PDFExposure to Rifampicin and its Metabolite 25-Deacetylrifampicin Rapidly Decreases During Tuberculosis Therapy.
Clin Pharmacokinet
January 2025
Facultés de Médecine et de Pharmacie de Lyon, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Background And Objective: Limited information is available on the pharmacokinetics of rifampicin (RIF) along with that of its active metabolite, 25-deacetylrifampicin (25-dRIF). This study aimed to analyse the pharmacokinetic data of RIF and 25-dRIF collected in adult patients treated for tuberculosis.
Methods: In adult patients receiving 10 mg/kg of RIF as part of a standard regimen for drug-susceptible pulmonary tuberculosis enrolled in the Opti-4TB study, plasma RIF and 25-dRIF concentrations were measured at various occasions.
Conduction system metastasis in a patient with carcinoma oesophagus.
BMJ Case Rep
January 2025
Cardiology, AIIMS, New Delhi, India
A young man in his 30s presented to us with multiple episodes of syncope and exertional dyspnoea for the last 2 weeks. He was diagnosed with squamous cell carcinoma of the lower one-third of the oesophagus in 2021 for which he was treated with neoadjuvant chemoradiotherapy, followed by McKeown oesophagectomy. At 2-year follow-up, he had developed a soft tissue swelling in the scalp, which was diagnosed as a tumour recurrence and radiotherapy was initiated.
View Article and Find Full Text PDFHypericin photoactivation induces triple-negative breast cancer cells pyroptosis by targeting the ROS/CALR/Caspase-3/GSDME pathway.
J Adv Res
January 2025
Cancer Institute, Xuzhou Medical University, 209 Tongshan Road, Xuzhou 221004 Jiangsu, China; Center of Clinical Oncology, The Afliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou 221002 Jiangsu, China; Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Xuzhou Medical University, 209 Tongshan Road, Xuzhou 221004 Jiangsu, China. Electronic address:
Introduction: Hypericin (HP), a natural photosensitizer, has demonstrated great efficacy in photodynamic therapy (PDT) for cancer treatment. In addition to the induction of apoptosis and necrosis through reactive oxygen species (ROS) generation, the therapeutic mechanisms and targets of PDT-HP remain unknown.
Objectives: To investigate the direct targets and mechanisms of action of photoactivated hypericin in the inhibition of triple-negative breast cancer (TNBC).
Introduction: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe hypersensitivity reaction rarely documented in patients with multiple myeloma (MM).
Methods: In our retrospective study of 108 newly diagnosed MM (NDMM) patients from January 2021 to October 2023, we identified four cases of DRESS. The clinical characteristics such as clinical manifestations, laboratory results, treatment and outcome were analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!