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Comparison of Alemtuzumab and Anti-thymocyte Globulin Treatment for Acute Kidney Allograft Rejection. | LitMetric

AI Article Synopsis

  • Rabbit anti-thymocyte globulin (rATG) is a common treatment for severe kidney transplant rejection, but it has serious side effects.
  • A study compared the outcomes of 116 patients treated with alemtuzumab to 108 patients treated with rATG, finding no significant differences in patient or allograft survival between the two groups.
  • However, alemtuzumab treatment showed better infection-free survival and fewer adverse infusion-related events, suggesting it could be a safer alternative for kidney transplant rejection cases resistant to glucocorticoids.

Article Abstract

Rabbit anti-thymocyte globulin (rATG) is currently the treatment of choice for glucocorticoid-resistant, recurrent, or severe acute allograft rejection (AR). However, rATG is associated with severe infusion-related side effects. Alemtuzumab is incidentally given to kidney transplant recipients as treatment for AR. In the current study, the outcomes of patients treated with alemtuzumab for AR were compared with that of patients treated with rATG for AR. The patient-, allograft-, and infection-free survival and adverse events of 116 alemtuzumab-treated patients were compared with those of 108 patients treated with rATG for AR. Propensity scores were used to control for differences between the two groups. Patient- and allograft survival of patients treated with either alemtuzumab or rATG were not different [hazard ratio (HR) 1.14, 95%-confidence interval (CI) 0.48-2.69, = 0.77, and HR 0.82, 95%-CI 0.45-1.5, = 0.52, respectively). Infection-free survival after alemtuzumab treatment was superior compared with that of rATG-treated patients (HR 0.41, 95%-CI 0.25-0.68, < 0.002). Infusion-related adverse events occurred less frequently after alemtuzumab treatment. Alemtuzumab therapy may therefore be an alternative therapy for glucocorticoid-resistant, recurrent, or severe acute kidney transplant rejection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350932PMC
http://dx.doi.org/10.3389/fimmu.2020.01332DOI Listing

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