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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2017 ; 96
(28
): e7151
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Alemtuzumab versus antithymocyte globulin induction therapies in kidney
transplantation patients: A systematic review and meta-analysis of randomized
controlled trials
#MMPMID28700465
Zheng J
; Song W
Medicine (Baltimore)
2017[Jul]; 96
(28
): e7151
PMID28700465
show ga
Alemtuzumab (ALEM) is widely used as an induction therapy for organ
transplantation, and numerous randomized controlled trials (RCTs) have been
published to evaluate its efficacy and safety in kidney transplantation as
compared with antithymocyte globulin (ATG). The purpose of this study was to
compare the benefits and safety of ALEM with those of ATG for induction therapy.A
systematic literature search in three electronic databases, including PubMed,
EmBase, and Cochrane Library, since inception through October 2016, was conducted
to identify potential RCTs for inclusion. Trials that investigated the risk of
biopsy-proven acute rejection (BPAR), mortality, graft failure, delayed graft
function (DGF), chronic allograft nephropathy (CAN), infections, cytomegalovirus
(CMV) infections, new-onset diabetes mellitus after transplant (NODAT), and
granulocyte colony stimulation factor (GCSF) use in kidney transplant recipients
who received ALEM or ATG as an induction therapy were included. Relative risk
(RR) and 95% confidence intervals (CIs) were calculated using a random-effects
model.Six RCTs involving 446 kidney transplantation patients were included in
this meta-analysis. The effects of ALEM therapy were not significantly different
from those of ATG therapy, including the incidence of BPAR (RR: 0.77; 95% CI:
0.51-1.18; P?=?.229), mortality (RR: 0.64; 95% CI: 0.30-1.39; P?=?.263), graft
failure (RR: 0.81; 95% CI: 0.49-1.33; P?=?.411), DGF (RR: 1.00; 95% CI:
0.60-1.67; P?=?.999), CAN (RR: 1.42; 95% CI: 0.44-4.57; P?=?.556), infections
(RR: 1.00; 95% CI: 0.74-1.35; P?=?.989), CMV infections (RR: 0.70; 95% CI:
0.38-1.30; P?=?.263), NODAT (RR: 0.50; 95% CI: 0.18-1.36; P?=?.174), and GCSF use
(RR: 1.16; 95% CI: 0.81-1.66; P?=?.413). Sensitivity analyses were consistent
with the overall analysis for all effects except CAN, suggesting that the risk of
CAN might be higher with ALEM therapy than ATG therapy (RR: 2.45; 95% CI:
1.02-5.94; P?=?.046).The findings of this study suggest that the beneficial
effects of ALEM therapy are greater than those of ATG therapy in kidney
transplantation patients; however, the effects were not statistically significant
because of the limited number of trials. Further large-scale RCTs are needed to
verify the treatment effects of ALEM.
|*Kidney Transplantation
[MESH]
|Alemtuzumab
[MESH]
|Antibodies, Monoclonal, Humanized/*therapeutic use
[MESH]