Clinical and economic analysis of short-course versus standard-course antithymocyte globulin (rabbit) induction therapy in deceased-donor renal transplant recipients

Kwaku Marfo, Enver Akalin, Cuiling Wang, Amy Lu

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8 Citations (Scopus)

Abstract

Purpose. The immunosuppressive effects of and costs associated with shortcourse antithymocyte globulin rabbit (ATG [rabbit]) therapy versus standard-course ATG (rabbit) therapy in deceased-donor renal transplant recipients were evaluated. Methods. The records of 84 consecutive patients who received a deceased-donor renal transplant at the Montefiore Einstein Center for Transplantation in 2008 were retrospectively reviewed. Donor and recipient characteristics, including rates of biopsy-confirmed acute rejection, serum creatinine (SCr) levels, and frequency of complications, and drug costs were collected. Patients were excluded if they had donor-specific antibodies identified before transplantation or hepatitis-C-positive serology or were under 18 years of age. Results. A total of 60 patients were included in the study, with 28 receiving short-course ATG (rabbit) therapy and 32 receiving standard-course ATG (rabbit) therapy. Baseline patient demographic characteristics were similar between groups. Six months after transplantation, biopsy-confirmed acute rejection episodes did not significantly differ between the short-course ATG (rabbit) and standardcourse ATG (rabbit) groups (17.8% versus 12.5%, respectively), nor did SCr concentrations (1.56 mg/dL versus 1.85 mg/dL). The frequency of therapy-related leukopenia was greater in patients receiving standardcourse ATG (rabbit). Patients treated with short-course ATG (rabbit) received a total mean dose of 4.6 mg/kg, compared with 7.3 mg/kg for patients in the standardcourse ATG (rabbit) group, resulting in a mean cost saving of $2548 per patient. Conclusion. After six months, there were no significant differences in biopsyconfirmed acute rejection episodes or SCr levels between deceased-donor renal transplant recipients receiving shortcourse versus standard-course ATG (rabbit) induction therapy. The mean cost saving associated with short-course therapy was $2548 per patient.

Original languageEnglish (US)
Pages (from-to)2276-2282
Number of pages7
JournalAmerican Journal of Health-System Pharmacy
Volume68
Issue number23
DOIs
StatePublished - Dec 1 2011

Fingerprint

Antilymphocyte Serum
Economics
Tissue Donors
Rabbits
Kidney
Therapeutics
Creatinine
Transplantation
Costs and Cost Analysis
Serum
Transplant Recipients
Biopsy
Drug Costs
Leukopenia
Serology
Immunosuppressive Agents
Hepatitis C
Demography
Transplants

Keywords

  • Antithymocyte globulin
  • Costs
  • Creatinine
  • Dosage
  • Dosage schedule
  • Graft rejection
  • Immunosuppressive agents
  • Pharmacoeconomics
  • Toxicity
  • Transplantation

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

Cite this

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title = "Clinical and economic analysis of short-course versus standard-course antithymocyte globulin (rabbit) induction therapy in deceased-donor renal transplant recipients",
abstract = "Purpose. The immunosuppressive effects of and costs associated with shortcourse antithymocyte globulin rabbit (ATG [rabbit]) therapy versus standard-course ATG (rabbit) therapy in deceased-donor renal transplant recipients were evaluated. Methods. The records of 84 consecutive patients who received a deceased-donor renal transplant at the Montefiore Einstein Center for Transplantation in 2008 were retrospectively reviewed. Donor and recipient characteristics, including rates of biopsy-confirmed acute rejection, serum creatinine (SCr) levels, and frequency of complications, and drug costs were collected. Patients were excluded if they had donor-specific antibodies identified before transplantation or hepatitis-C-positive serology or were under 18 years of age. Results. A total of 60 patients were included in the study, with 28 receiving short-course ATG (rabbit) therapy and 32 receiving standard-course ATG (rabbit) therapy. Baseline patient demographic characteristics were similar between groups. Six months after transplantation, biopsy-confirmed acute rejection episodes did not significantly differ between the short-course ATG (rabbit) and standardcourse ATG (rabbit) groups (17.8{\%} versus 12.5{\%}, respectively), nor did SCr concentrations (1.56 mg/dL versus 1.85 mg/dL). The frequency of therapy-related leukopenia was greater in patients receiving standardcourse ATG (rabbit). Patients treated with short-course ATG (rabbit) received a total mean dose of 4.6 mg/kg, compared with 7.3 mg/kg for patients in the standardcourse ATG (rabbit) group, resulting in a mean cost saving of $2548 per patient. Conclusion. After six months, there were no significant differences in biopsyconfirmed acute rejection episodes or SCr levels between deceased-donor renal transplant recipients receiving shortcourse versus standard-course ATG (rabbit) induction therapy. The mean cost saving associated with short-course therapy was $2548 per patient.",
keywords = "Antithymocyte globulin, Costs, Creatinine, Dosage, Dosage schedule, Graft rejection, Immunosuppressive agents, Pharmacoeconomics, Toxicity, Transplantation",
author = "Kwaku Marfo and Enver Akalin and Cuiling Wang and Amy Lu",
year = "2011",
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language = "English (US)",
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pages = "2276--2282",
journal = "American Journal of Health-System Pharmacy",
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TY - JOUR

T1 - Clinical and economic analysis of short-course versus standard-course antithymocyte globulin (rabbit) induction therapy in deceased-donor renal transplant recipients

AU - Marfo, Kwaku

AU - Akalin, Enver

AU - Wang, Cuiling

AU - Lu, Amy

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Purpose. The immunosuppressive effects of and costs associated with shortcourse antithymocyte globulin rabbit (ATG [rabbit]) therapy versus standard-course ATG (rabbit) therapy in deceased-donor renal transplant recipients were evaluated. Methods. The records of 84 consecutive patients who received a deceased-donor renal transplant at the Montefiore Einstein Center for Transplantation in 2008 were retrospectively reviewed. Donor and recipient characteristics, including rates of biopsy-confirmed acute rejection, serum creatinine (SCr) levels, and frequency of complications, and drug costs were collected. Patients were excluded if they had donor-specific antibodies identified before transplantation or hepatitis-C-positive serology or were under 18 years of age. Results. A total of 60 patients were included in the study, with 28 receiving short-course ATG (rabbit) therapy and 32 receiving standard-course ATG (rabbit) therapy. Baseline patient demographic characteristics were similar between groups. Six months after transplantation, biopsy-confirmed acute rejection episodes did not significantly differ between the short-course ATG (rabbit) and standardcourse ATG (rabbit) groups (17.8% versus 12.5%, respectively), nor did SCr concentrations (1.56 mg/dL versus 1.85 mg/dL). The frequency of therapy-related leukopenia was greater in patients receiving standardcourse ATG (rabbit). Patients treated with short-course ATG (rabbit) received a total mean dose of 4.6 mg/kg, compared with 7.3 mg/kg for patients in the standardcourse ATG (rabbit) group, resulting in a mean cost saving of $2548 per patient. Conclusion. After six months, there were no significant differences in biopsyconfirmed acute rejection episodes or SCr levels between deceased-donor renal transplant recipients receiving shortcourse versus standard-course ATG (rabbit) induction therapy. The mean cost saving associated with short-course therapy was $2548 per patient.

AB - Purpose. The immunosuppressive effects of and costs associated with shortcourse antithymocyte globulin rabbit (ATG [rabbit]) therapy versus standard-course ATG (rabbit) therapy in deceased-donor renal transplant recipients were evaluated. Methods. The records of 84 consecutive patients who received a deceased-donor renal transplant at the Montefiore Einstein Center for Transplantation in 2008 were retrospectively reviewed. Donor and recipient characteristics, including rates of biopsy-confirmed acute rejection, serum creatinine (SCr) levels, and frequency of complications, and drug costs were collected. Patients were excluded if they had donor-specific antibodies identified before transplantation or hepatitis-C-positive serology or were under 18 years of age. Results. A total of 60 patients were included in the study, with 28 receiving short-course ATG (rabbit) therapy and 32 receiving standard-course ATG (rabbit) therapy. Baseline patient demographic characteristics were similar between groups. Six months after transplantation, biopsy-confirmed acute rejection episodes did not significantly differ between the short-course ATG (rabbit) and standardcourse ATG (rabbit) groups (17.8% versus 12.5%, respectively), nor did SCr concentrations (1.56 mg/dL versus 1.85 mg/dL). The frequency of therapy-related leukopenia was greater in patients receiving standardcourse ATG (rabbit). Patients treated with short-course ATG (rabbit) received a total mean dose of 4.6 mg/kg, compared with 7.3 mg/kg for patients in the standardcourse ATG (rabbit) group, resulting in a mean cost saving of $2548 per patient. Conclusion. After six months, there were no significant differences in biopsyconfirmed acute rejection episodes or SCr levels between deceased-donor renal transplant recipients receiving shortcourse versus standard-course ATG (rabbit) induction therapy. The mean cost saving associated with short-course therapy was $2548 per patient.

KW - Antithymocyte globulin

KW - Costs

KW - Creatinine

KW - Dosage

KW - Dosage schedule

KW - Graft rejection

KW - Immunosuppressive agents

KW - Pharmacoeconomics

KW - Toxicity

KW - Transplantation

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