Anti-interleukin-2 receptor antibodies-basiliximab and daclizumab-for the prevention of acute rejection in renal transplantation

Junichiro Sageshima, Gaetano Ciancio, Linda Chen, George W. Burke

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

The use of antibody induction after kidney transplantation has increased from 25% to 63% in the past decade and roughly one half of the induction agent used is anti-interleukin-2 receptor antibody (IL-2RA, ie, basiliximab or daclizumab). When combined with calcineurin inhibitor (CNI)-based immunosuppression, IL-2RAs have been shown to reduce the incidence of acute rejection, one of the predictors of poor graft survival, without increasing risks of infections and malignancies in kidney transplantation. For low-immunological-risk patients, IL-2RAs, as compared with lymphocyte-depleting antibodies, are equally efficacious and have better safety profiles. For high-risk patients, however, IL-2RAs may be inferior to lymphocyte-depleting antibodies for the prophylaxis of acute rejection. In an effort to reduce toxicities of other immunosuppressive medications without increasing the risk of acute rejection and chronic graft loss, IL-2RAs have often been combined with steroid- and CNI-sparing immunosuppression protocols. More data support the benefits of early steroid withdrawal with IL-2RA in low-risk patients, but preferred induction therapy for high-risk patients has yet to be determined. Although CNI-sparing protocols with IL-2RA may preserve renal function and improve long-term survival in selected patients, further studies are needed to identify those who benefit most from this strategy.

Original languageEnglish (US)
Pages (from-to)319-336
Number of pages18
JournalBiologics: Targets and Therapy
Volume3
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

Fingerprint

Interleukin-2 Receptors
Kidney Transplantation
Antibodies
Immunosuppression
Steroids
Lymphocytes
Graft Rejection
Graft Survival
Immunosuppressive Agents
daclizumab
basiliximab
Kidney
Safety
Survival
Incidence
Infection
Calcineurin Inhibitors
Neoplasms

Keywords

  • Basiliximab
  • Daclizumab
  • Interleukin-2 receptor antagonist
  • Kidney transplantation
  • Monoclonal antibody

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Oncology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Anti-interleukin-2 receptor antibodies-basiliximab and daclizumab-for the prevention of acute rejection in renal transplantation. / Sageshima, Junichiro; Ciancio, Gaetano; Chen, Linda; Burke, George W.

In: Biologics: Targets and Therapy, Vol. 3, 01.01.2009, p. 319-336.

Research output: Contribution to journalReview article

@article{24322d1534124e468c5186ec06980c95,
title = "Anti-interleukin-2 receptor antibodies-basiliximab and daclizumab-for the prevention of acute rejection in renal transplantation",
abstract = "The use of antibody induction after kidney transplantation has increased from 25{\%} to 63{\%} in the past decade and roughly one half of the induction agent used is anti-interleukin-2 receptor antibody (IL-2RA, ie, basiliximab or daclizumab). When combined with calcineurin inhibitor (CNI)-based immunosuppression, IL-2RAs have been shown to reduce the incidence of acute rejection, one of the predictors of poor graft survival, without increasing risks of infections and malignancies in kidney transplantation. For low-immunological-risk patients, IL-2RAs, as compared with lymphocyte-depleting antibodies, are equally efficacious and have better safety profiles. For high-risk patients, however, IL-2RAs may be inferior to lymphocyte-depleting antibodies for the prophylaxis of acute rejection. In an effort to reduce toxicities of other immunosuppressive medications without increasing the risk of acute rejection and chronic graft loss, IL-2RAs have often been combined with steroid- and CNI-sparing immunosuppression protocols. More data support the benefits of early steroid withdrawal with IL-2RA in low-risk patients, but preferred induction therapy for high-risk patients has yet to be determined. Although CNI-sparing protocols with IL-2RA may preserve renal function and improve long-term survival in selected patients, further studies are needed to identify those who benefit most from this strategy.",
keywords = "Basiliximab, Daclizumab, Interleukin-2 receptor antagonist, Kidney transplantation, Monoclonal antibody",
author = "Junichiro Sageshima and Gaetano Ciancio and Linda Chen and Burke, {George W.}",
year = "2009",
month = "1",
day = "1",
doi = "10.2147/BTT.S3258",
language = "English (US)",
volume = "3",
pages = "319--336",
journal = "Biologics: Targets and Therapy",
issn = "1177-5475",
publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - Anti-interleukin-2 receptor antibodies-basiliximab and daclizumab-for the prevention of acute rejection in renal transplantation

AU - Sageshima, Junichiro

AU - Ciancio, Gaetano

AU - Chen, Linda

AU - Burke, George W.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - The use of antibody induction after kidney transplantation has increased from 25% to 63% in the past decade and roughly one half of the induction agent used is anti-interleukin-2 receptor antibody (IL-2RA, ie, basiliximab or daclizumab). When combined with calcineurin inhibitor (CNI)-based immunosuppression, IL-2RAs have been shown to reduce the incidence of acute rejection, one of the predictors of poor graft survival, without increasing risks of infections and malignancies in kidney transplantation. For low-immunological-risk patients, IL-2RAs, as compared with lymphocyte-depleting antibodies, are equally efficacious and have better safety profiles. For high-risk patients, however, IL-2RAs may be inferior to lymphocyte-depleting antibodies for the prophylaxis of acute rejection. In an effort to reduce toxicities of other immunosuppressive medications without increasing the risk of acute rejection and chronic graft loss, IL-2RAs have often been combined with steroid- and CNI-sparing immunosuppression protocols. More data support the benefits of early steroid withdrawal with IL-2RA in low-risk patients, but preferred induction therapy for high-risk patients has yet to be determined. Although CNI-sparing protocols with IL-2RA may preserve renal function and improve long-term survival in selected patients, further studies are needed to identify those who benefit most from this strategy.

AB - The use of antibody induction after kidney transplantation has increased from 25% to 63% in the past decade and roughly one half of the induction agent used is anti-interleukin-2 receptor antibody (IL-2RA, ie, basiliximab or daclizumab). When combined with calcineurin inhibitor (CNI)-based immunosuppression, IL-2RAs have been shown to reduce the incidence of acute rejection, one of the predictors of poor graft survival, without increasing risks of infections and malignancies in kidney transplantation. For low-immunological-risk patients, IL-2RAs, as compared with lymphocyte-depleting antibodies, are equally efficacious and have better safety profiles. For high-risk patients, however, IL-2RAs may be inferior to lymphocyte-depleting antibodies for the prophylaxis of acute rejection. In an effort to reduce toxicities of other immunosuppressive medications without increasing the risk of acute rejection and chronic graft loss, IL-2RAs have often been combined with steroid- and CNI-sparing immunosuppression protocols. More data support the benefits of early steroid withdrawal with IL-2RA in low-risk patients, but preferred induction therapy for high-risk patients has yet to be determined. Although CNI-sparing protocols with IL-2RA may preserve renal function and improve long-term survival in selected patients, further studies are needed to identify those who benefit most from this strategy.

KW - Basiliximab

KW - Daclizumab

KW - Interleukin-2 receptor antagonist

KW - Kidney transplantation

KW - Monoclonal antibody

UR - http://www.scopus.com/inward/record.url?scp=77955530237&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955530237&partnerID=8YFLogxK

U2 - 10.2147/BTT.S3258

DO - 10.2147/BTT.S3258

M3 - Review article

AN - SCOPUS:77955530237

VL - 3

SP - 319

EP - 336

JO - Biologics: Targets and Therapy

JF - Biologics: Targets and Therapy

SN - 1177-5475

ER -