Comparison of daclizumab, an interleukin 2 receptor antibody, to anti-thymocyte globulin-Fresenius induction therapy in kidney transplantation

Abstract

The efficacy and safety of daclizumab and anti-thymocyte globulin-Fresenius (ATG-F) as induction therapy in kidney transplantation (KT) were investigated in 45 KT performed in our center between March and May 2002. Group II (n=10) received daclizumab as induction therapy, and Group I (n=35) were induced with a single intraoperative bolus therapy of ATG-F. All patients were at low-risk, and the recipient and donor demographics, as well the immunosuppression regimen employed were comparable in both groups. Drug safety, assessed by the occurrence of side effects, was almost comparable in the two groups, except for more thrombocytopenia in Group II (P<0.0004). Acute rejection (AR) occurred in 10% in Group I and 11.4% in Group II (P=NS). There were more infections in Group II (42.8%) than in Group I (10%) (P<0.009). Bacterial and viral infections were more common in Group II (69 and 23%) than in Group I (10 and 0%) (P<0.05). The hospital stay was similar in both groups. Mean serum creatinine levels upon discharge, at 1, 3 and 6 months were: 1.23±0.11, 1.21±0.06, 1.25±0.11 and 1.35±0.08 in Group I and 2.18±0.43, 1.49±0.16, 1.49±0.16 and 1.35±0.08 in Group II, respectively. While better serum creatinine levels were observed in Group I upon discharge (P<0.048), this was due to the presence of more sensitized patients in Group II. The 6 months actuarial patient and graft survival were identical in both groups (100 and 100%, respectively). Although both daclizumab and ATG-F were effective and safe as induction therapy in KT, less bacterial and viral infections and lower early serum creatinine levels were noted in daclizumab-treated patients.