Comparing Outcomes between Antibody Induction Therapies in Kidney Transplantation

Kidney transplant recipients often receive antibody induction. Previous studies of induction therapy were often limited by short follow-up and/or absence of information about complications. After linking Organ Procurement and Transplantation Network data with Medicare claims, we compared outcomes be...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American Society of Nephrology 2017-07, Vol.28 (7), p.2188-2200
Main Authors: Koyawala, Neel, Silber, Jeffrey H, Rosenbaum, Paul R, Wang, Wei, Hill, Alexander S, Reiter, Joseph G, Niknam, Bijan A, Even-Shoshan, Orit, Bloom, Roy D, Sawinski, Deirdre, Nazarian, Susanna, Trofe-Clark, Jennifer, Lim, Mary Ann, Schold, Jesse D, Reese, Peter P
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alemtuzumab
Animals
Antibodies - immunology
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Antilymphocyte Serum - therapeutic use
Clinical Epidemiology
Cohort Studies
Female
Humans
Immunosuppressive Agents - therapeutic use
Kidney Transplantation
Male
Middle Aged
Rabbits
Recombinant Fusion Proteins - therapeutic use
Retrospective Studies
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Kidney transplant recipients often receive antibody induction. Previous studies of induction therapy were often limited by short follow-up and/or absence of information about complications. After linking Organ Procurement and Transplantation Network data with Medicare claims, we compared outcomes between three induction therapies for kidney recipients. Using novel matching techniques developed on the basis of 15 clinical and demographic characteristics, we generated 1:1 pairs of alemtuzumab-rabbit antithymocyte globulin (rATG) (5330 pairs) and basiliximab-rATG (9378 pairs) recipients. We used paired Cox regression to analyze the primary outcomes of death and death or allograft failure. Secondary outcomes included death or sepsis, death or lymphoma, death or melanoma, and healthcare resource utilization within 1 year. Compared with rATG recipients, alemtuzumab recipients had higher risk of death (hazard ratio [HR], 1.14; 95% confidence interval [95% CI], 1.03 to 1.26;
ISSN:1046-6673
1533-3450
DOI:10.1681/ASN.2016070768