Basiliximab vs. limited-dose daclizumab (2 mg/kg) administered in single or two separated doses in kidney transplantation.

Abstract

INTRODUCTION: Addition of anti-IL2r monoclonal antibodies (chimeric or humanized) for induction therapy has reduced the frequency of acute rejection (AR). This study compares the impact of type and dosage of induction therapy on frequency of acute rejection and on renal function during the first year post-transplant. PATIENTS AND METHODS: Comparative retrospective study. Kidney transplant recipients (KTR) were divided in three groups according to induction therapy, as follows: (1) Basiliximab in two 20 mg doses, (2) Daclizumab 2 mg/kg in one dose, and (3) Daclizumab 2 mg/kg divided in two doses (1 mg/kg each). Groups were paired for age, sex, number of shared haplotypes, and previous transplant history. Primary endpoints were AR episodes, time to first AR, graft loss, and death. Secondary endpoints were SCr (at 3, 6, 9 and 12 months), frequency and type of infection, and cost. RESULTS: There were no baseline differences between groups. Twenty one patients were included in each group. The incidence of AR was similar: 14.2% in group 1, and 9.5% for groups 2 and 3. Two deaths were reported, one in group 1 and another in group 2. Mean SCr was similar between groups. Incidence of infection was 6, 5, and 7 in groups 1 to 3, respectively without a significant difference. The cost was higher in group 1 (p < 0.001). CONCLUSION: Low dose Daclizumab in one or two doses is equally effective and safe as basiliximab at 12-month follow-up, with inferior cost.