More Cost-Effective Immunosuppressant for Transplants Identified
The results of the first head-to-head comparison of the three most common drugs used at the time of a kidney transplant to prevent organ rejection have been published in the New England Journal of Medicine (May 19, 2011).
Based at University of Alabama at Birmingham, researchers in the INTAC trial spent three years following 474 patients who had undergone kidney transplants at 30 U.S. transplant centres. They compared the drugs basiliximab, antithymocyte globulin and alemtuzumab to definitively answer which of the three would be the most appropriate to prescribe to prevent rejection during the first 6 to 12 months following transplant surgery, when rejection is most likely. These are intravenous drugs given at the time of transplant in the operating room or early in the first week after transplant and are intensive immunosuppressants, designed to prevent early rejection. The use of these drugs is known as induction therapy.They are used in coordination with other standard post-transplant medications.
The researchers found that alemtuzumab, which costs around $2,000, worked better than or as well as either basiliximab or antithymocyte globulin, which cost about $4,000 and $10,000, respectively. Patients enrolled in the trial were first classified as being at a low or high risk of transplant rejection - high-risk patients included more African-Americans and patients already sensitised to transplantation from a previous transplant. Low-risk patients were randomly assigned to receive either basiliximab or alemtuzumab. High-risk patients were randomized into receiving antithymocyte globulin or alemtuzumab.Researchers then compared the efficacy and safety of basiliximab and antithymocyte globulin with that of alemtuzumab.
"We found there was less rejection in the lowrisk patients when using alemtuzumab and about the same amount of rejection in high risk patients. What makes alemtuzumab different is the cost. Now that we know there is not any more rejection or infections with alemtuzumab, it makes sense to go with the one that is cheaper and just as effective," said the study's lead author, Michael Hanaway, M.D., surgeon in the Division of Abdominal Transplantation at UAB. Hanaway added that while there are limitations to the study and future studies are needed to address these limitations, UAB transplant surgeons began using alemtuzumab three years ago based on early results from this study.
- Copyright ©2018. Published by MOHAN Foundation
- Keywords: Immunosuppressant, drug trial, Transplant