title: Efficacy of Daclizumab in an African-American and Hispanic renal transplant population.
abstract: Current immunosuppressive regimens have decreased acute rejection rates during the 1st year after renal transplantation. However, this decrease has not been as marked in high-risk groups, such as African-American and Hispanic renal transplant recipients. We compared two simultaneous cohorts of altogether 36 African-American and Hispanic renal transplant recipients. Cohort one received a regimen of mycophenolate mofetil, prednisone, and a calcineurin inhibitor. The second cohort received the same protocol with the addition of Daclizumab (1 mg/kg for five doses given every 2 weeks). The median follow-up was 15.2 months (range 11.8-19.9 months). One patient in the Daclizumab-treated group and seven patients in the control group experienced an acute rejection episode. The rejection-free survival was significantly higher in the Daclizumab-treated group (94.4 %) as compared to the control group (66.7 %, Log-rank < 0.05) at 17 months after transplantation. A Cox Proportional Hazard model revealed lack of Daclizumab therapy as the only significant risk factor for acute rejection. (hazard ratio 7.0, 95 % CI = 1.1-48). The addition of the IL-2 receptor blocker Daclizumab to a triple therapy regimen may decrease early acute rejection in the high-risk groups of African-American and Hispanic patients.
authors.affiliation: Division of Renal Disease and Hypertension, University of Texas at Houston, 77030, USA.
authors.forename: H U
authors.initials: HU
authors.lastname: Meier-Kriesche
authors.forename: S S
authors.initials: SS
authors.lastname: Palenkar
authors.forename: G S
authors.initials: GS
authors.lastname: Friedman
authors.forename: S P
authors.initials: SP
authors.lastname: Mulgaonkar
authors.forename: M V
authors.initials: MV
authors.lastname: Goldblat
authors.forename: B
authors.initials: B
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D044383:Black People; D065095:Calcineurin Inhibitors; D015331:Cohort Studies; D000077561:Daclizumab; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011241:Prednisone / Q000008:administration & dosage; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D065095:Calcineurin Inhibitors; D004791:Enzyme Inhibitors; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D000077561:Daclizumab; D009173:Mycophenolic Acid; D011241:Prednisone