15-Deoxyspergualin "rescue therapy" for methylprednisolone-resistant rejection of renal transplants as compared with anti-T cell monoclonal antibody (OKT3).
A randomized trial with OKT3, an anti-T cell monoclonal antibody or with 15-deoxyspergualin against methylprednisolone-resistant rejection crisis was performed in 25 posttransplant patients immunosuppressed with prednisolone and cyclosporine. At least temporary reversal of rejection was observed in 58.3% of patients treated with 15-deoxyspergualin. This reversal rate may be quite comparable to 61.5% seen in patients treated with OKT3. Adverse effects with 15-deoxyspergualin were related to bone marrow suppression, while those with OKT3 were pyrexia, gastrointestinal symptoms, and herpes infection. In contrast to OKT3, which may act by modulating T cell surface antigen, 15-deoxyspergualin may be effective somewhere in the later stages of the rejection cascade.
Okubo
M
M
Department of Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Tamura
K
K
Kamata
K
K
Tsukamoto
Y
Y
Nakayama
Y
Y
Osakabe
T
T
Sato
K
K
Go
M
M
Kumano
K
K
Endo
T
T
D000328:Adult; D003404:Creatinine / Q000097:blood; D004351:Drug Resistance; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006146:Guanidines / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D016853:Muromonab-CD3 / Q000009:adverse effects / Q000627:therapeutic use*; D016879:Salvage Therapy
D006146:Guanidines; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D003404:Creatinine; C037258:gusperimus; D008775:Methylprednisolone