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Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation.

Publication ,  Journal Article
Gaber, AO; First, MR; Tesi, RJ; Gaston, RS; Mendez, R; Mulloy, LL; Light, JA; Gaber, LW; Squiers, E; Taylor, RJ; Neylan, JF; Steiner, RW ...
Published in: Transplantation
July 15, 1998

BACKGROUND: Thymoglobulin, a rabbit anti-human thymocyte globulin, was compared with Atgam, a horse anti-human thymocyte globulin for the treatment of acute rejection after renal transplantation. METHODS: A multicenter, double-blind, randomized trial with enrollment stratification based on standardized histology (Banff grading) was conducted. Subjects received 7-14 days of Thymoglobulin (1.5 mg/kg/ day) or Atgam (15 mg/kg/day). The primary end point was rejection reversal (return of serum creatinine level to or below the day 0 baseline value). RESULTS: A total of 163 patients were enrolled at 25 transplant centers in the United States. No differences in demographics or transplant characteristics were noted. Intent-to-treat analysis demonstrated that Thymoglobulin had a higher rejection reversal rate than Atgam (88% versus 76%, P=0.027, primary end point). Day 30 graft survival rates (Thymoglobulin 94% and Atgam 90%, P=0.17), day 30 serum creatinine levels as a percentage of baseline (Thymoglobulin 72% and Atgam 80%; P=0.43), and improvement in posttreatment biopsy results (Thymoglobulin 65% and Atgam 50%; P=0.15) were not statistically different. T-cell depletion was maintained more effectively with Thymoglobulin than Atgam both at the end of therapy (P=0.001) and at day 30 (P=0.016). Recurrent rejection, at 90 days after therapy, occurred less frequently with Thymoglobulin (17%) versus Atgam (36%) (P=0.011). A similar incidence of adverse events, post-therapy infections, and 1-year patient and graft survival rates were observed with both treatments. CONCLUSIONS: Thymoglobulin was found to be superior to Atgam in reversing acute rejection and preventing recurrent rejection after therapy in renal transplant recipients.

Duke Scholars

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

July 15, 1998

Volume

66

Issue

1

Start / End Page

29 / 37

Location

United States

Related Subject Headings

  • Surgery
  • Rabbits
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunosuppressive Agents
  • Humans
  • Graft Rejection
  • Female
  • Double-Blind Method
 

Citation

APA
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MLA
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Gaber, A. O., First, M. R., Tesi, R. J., Gaston, R. S., Mendez, R., Mulloy, L. L., … Schroeder, T. J. (1998). Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation. Transplantation, 66(1), 29–37. https://doi.org/10.1097/00007890-199807150-00005
Gaber, A. O., M. R. First, R. J. Tesi, R. S. Gaston, R. Mendez, L. L. Mulloy, J. A. Light, et al. “Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation.Transplantation 66, no. 1 (July 15, 1998): 29–37. https://doi.org/10.1097/00007890-199807150-00005.
Gaber, A. O., et al. “Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation.Transplantation, vol. 66, no. 1, July 1998, pp. 29–37. Pubmed, doi:10.1097/00007890-199807150-00005.
Gaber AO, First MR, Tesi RJ, Gaston RS, Mendez R, Mulloy LL, Light JA, Gaber LW, Squiers E, Taylor RJ, Neylan JF, Steiner RW, Knechtle S, Norman DJ, Shihab F, Basadonna G, Brennan DC, Hodge EE, Kahan BD, Kahan L, Steinberg S, Woodle ES, Chan L, Ham JM, Schroeder TJ. Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation. Transplantation. 1998 Jul 15;66(1):29–37.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

July 15, 1998

Volume

66

Issue

1

Start / End Page

29 / 37

Location

United States

Related Subject Headings

  • Surgery
  • Rabbits
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Immunosuppressive Agents
  • Humans
  • Graft Rejection
  • Female
  • Double-Blind Method