Kidney Transplant: Rejection Decreased By New Drug Regimen

MedicalResearch.com Interview with
Dr. Richard Haynes
Clinical Trial Service Unit and Epidemiological Studies Unit
Roosevelt Drive, Headington
Oxford OX3

Medical Research: What are the main findings of the study?

Dr. Haynes: The main result from this analysis is that alemtuzumab-based induction therapy (ie, alemtuzumab followed by low-dose mycophenolate and tacrolimus with steroid avoidance) reduced biopsy-proven acute rejection by about half during the first 6 months after transplantation among a wide variety of different types of participant, compared to standard basiliximab-based induction therapy (basiliximab followed by standard dose mycophenolate, tacrolimus and steroids). This reduction was achieved despite the lower doses of tacrolimus used and there was no excess of infection observed.

Medical Research: Were any of the findings unexpected?

Dr. Haynes: It was known before the trial began that alemtuzumab could reduce rejection, but previous trials had not combined it with lower doses of tacrolimus. Also, previous trials had suggested an excess of infections which this larger trial did not observe.

Medical Research: What should clinicians and patients take away from your report?

Dr. Haynes: Alemtuzumab-based induction therapy appears to provide excellent short-term results in kidney transplantation. However, these results are only short-term and longer-term results may be necessary before clinical practice changes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Haynes: The long-term results of this comparison are essential to understand whether these short-term benefits translate into long-term improvements in outcome. Such long-term follow-up is underway with the 3C Study. The search for new treatments is important, but so is finding ways to improve existing treatment and make the most of what we have.

Citation:

Alemtuzumab-based induction treatment versus basiliximab-based induction treatment in kidney transplantation (the 3C Study): a randomised trial
The 3C Study Collaborative Group
The Lancet – 28 July 2014
DOI: 10.1016/S0140-6736(14)61095-3