Rabbit anti-thymocyte globulin (rATG) versus IL-2 receptor antagonist induction therapies in tacrolimus-based immunosuppression era : a meta-analysis
BACKGROUND: The aim of this meta-analysis is to explore the effect of IL-2RA vs rATG on the rate of acute rejection, post-transplant infections, and graft as well as patient's survival in standard- and high-risk renal transplant patients receiving tacrolimus-based maintenance immunotherapy.
METHODS: Random effects model was the method used for identifying risk difference. Confidence interval including the value 1 was used as evidence for statistically significant risk difference. Heterogeneity was assessed using Der Simonian analysis. Heterogeneity was evident at the level of P value < 0.1 RESULTS: The random effects model showed no significant differences in both acute rejection rates between IL-2RA and rATG induction therapies with relative risk of 1.24 graft survival with relative risk 0.90. Patient survival also did not demonstrate any significant difference with a relative risk of 1.19. Random effects for CMV infection showed a lesser tendency for CMV infection in IL-2RA group compared to ATG group the with a relative risk of 0.73.In subgroup analysis, the random effects model for acute rejection rates in high-risk transplants showed a higher risk of acute rejection in the IL-2RA group compared to rATG (relative risk equals 1.55) In standard-risk transplants, there were no significant differences between both groups with relative risk equals 1.02 CONCLUSIONS: This meta-analysis revealed no significant difference in patient and graft survival when using IL-2RA vs rATG with the tacrolimus-based maintenance immunosuppression era. However, subgroup analysis showed less incidence of rejection in high-risk renal transplant recipient's population using rATG compared to IL-2RA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
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| Enthalten in: |
International urology and nephrology - 52(2020), 4 vom: 13. Apr., Seite 791-802 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ali, Hatem [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.01.2021 Date Revised 26.01.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11255-020-02418-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307586073 |
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| 100 | 1 | |a Ali, Hatem |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rabbit anti-thymocyte globulin (rATG) versus IL-2 receptor antagonist induction therapies in tacrolimus-based immunosuppression era |b a meta-analysis |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 26.01.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The aim of this meta-analysis is to explore the effect of IL-2RA vs rATG on the rate of acute rejection, post-transplant infections, and graft as well as patient's survival in standard- and high-risk renal transplant patients receiving tacrolimus-based maintenance immunotherapy | ||
| 520 | |a METHODS: Random effects model was the method used for identifying risk difference. Confidence interval including the value 1 was used as evidence for statistically significant risk difference. Heterogeneity was assessed using Der Simonian analysis. Heterogeneity was evident at the level of P value < 0.1 RESULTS: The random effects model showed no significant differences in both acute rejection rates between IL-2RA and rATG induction therapies with relative risk of 1.24 graft survival with relative risk 0.90. Patient survival also did not demonstrate any significant difference with a relative risk of 1.19. Random effects for CMV infection showed a lesser tendency for CMV infection in IL-2RA group compared to ATG group the with a relative risk of 0.73.In subgroup analysis, the random effects model for acute rejection rates in high-risk transplants showed a higher risk of acute rejection in the IL-2RA group compared to rATG (relative risk equals 1.55) In standard-risk transplants, there were no significant differences between both groups with relative risk equals 1.02 CONCLUSIONS: This meta-analysis revealed no significant difference in patient and graft survival when using IL-2RA vs rATG with the tacrolimus-based maintenance immunosuppression era. However, subgroup analysis showed less incidence of rejection in high-risk renal transplant recipient's population using rATG compared to IL-2RA | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Calcineurin inhibitors | |
| 650 | 4 | |a Induction therapy | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Renal transplant | |
| 650 | 4 | |a Tacrolimus | |
| 650 | 7 | |a Antilymphocyte Serum |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Receptors, Interleukin-2 |2 NLM | |
| 650 | 7 | |a Basiliximab |2 NLM | |
| 650 | 7 | |a 9927MT646M |2 NLM | |
| 650 | 7 | |a Daclizumab |2 NLM | |
| 650 | 7 | |a CUJ2MVI71Y |2 NLM | |
| 650 | 7 | |a thymoglobulin |2 NLM | |
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| 650 | 7 | |a Tacrolimus |2 NLM | |
| 650 | 7 | |a WM0HAQ4WNM |2 NLM | |
| 700 | 1 | |a Soliman, Karim M |e verfasserin |4 aut | |
| 700 | 1 | |a Shaheen, Ihab |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jon Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Kossi, Mohsen El |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Ajay |e verfasserin |4 aut | |
| 700 | 1 | |a Pararajasingam, Ravi |e verfasserin |4 aut | |
| 700 | 1 | |a Halawa, Ahmed |e verfasserin |4 aut | |
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