title: Cyclosporine-sparing effect of basiliximab in renal transplant recipients with mycophenolate mofetil.
abstract: Basiliximab added to a maintenance regimen consisting of cyclosporine microemulsion and mycophenolate mofetil was studied for its effectiveness in allowing early steroid withdrawal in renal transplantation. Furthermore, the cyclosporine-sparing effects between groups with and without basiliximab induction therapy were compared.
  
  
  METHODS
  Between September 2001 and June 2003, 90 patients underwent renal transplants with cyclosporine-based immunosuppression, namely, cyclosporine, mycophenolate mofetil, and methylprednisolone, (group 1; n = 25). During the latter half of the study basiliximab was administered during the induction phase (group 2; n = 65). In group 2, steroids were completely withdrawn on postoperative day 14 in 57 patients.
  
  
  RESULTS
  The incidence of acute rejection was significantly higher among group 1 patients (P = .005). The incidence of steroid-resistant rejection in group 1 patients was significantly higher (P = .025). At each time point cyclosporine levels in group 1 patients were significantly higher (P < .01). The incidence of infection was comparable between the groups. Patient and graft survival rates in group 1 were 100% and 100%; in group 2, they were 99% and 99%, respectively. In group 2, steroids were discontinued in 57 patients with permanent withdrawal achieved in 32 patients (56%).
  
  
  CONCLUSIONS
  The use of basiliximab, together with mycophenolate mofetil allowed for a significant reduction in the cyclosporine dose without increasing the risk of acute rejection. Although further follow-up is necessary to confirm the effect, this regimen may attenuate cyclosporine nephrotoxicity thereby affecting the long-term outcomes of renal transplantation.
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tojimbara
authors.forename: S
authors.initials: S
authors.lastname: Sato
authors.forename: I
authors.initials: I
authors.lastname: Koyama
authors.forename: K
authors.initials: K
authors.lastname: Nanmoku
authors.forename: M
authors.initials: M
authors.lastname: Sekijima
authors.forename: M
authors.initials: M
authors.lastname: Tonsyo
authors.forename: K
authors.initials: K
authors.lastname: Kai
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Urashima
authors.forename: I
authors.initials: I
authors.lastname: Nakajima
authors.forename: S
authors.initials: S
authors.lastname: Fuchinoue
authors.forename: S
authors.initials: S
authors.lastname: Teraoka
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D016572:Cyclosporine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D009173:Mycophenolic Acid; D008775:Methylprednisolone