Induction Immunosuppressive Therapies in Renal Transplantation

Steven Gabardi, Pharm.D., BCPS; Spencer T. Martin, Pharm.D., BCPS; Keri L. Roberts, Pharm.D.; Monica Grafals, M.D.

Am J Health Syst Pharm. 2011;68(3):211-218.

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Articles for this review were identified through searches of MEDLINE (January 1965–April 2010) using the search terms induction therapy, renal transplantation, antithymocyte globulin rabbit, antithymocyte globulin horse, muromonab-CD3, basiliximab, daclizumab, and alemtuzumab. Bibliographies of articles retrieved were also reviewed for relevant trials. Clinical trials were included if they involved renal transplant recipients, included a control group, and were deemed to be of moderate-to-high quality. All English-language in vitro and in vivo studies evaluating induction therapy agents were also reviewed and considered for inclusion.

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Cite this: Induction Immunosuppressive Therapies in Renal Transplantation - Medscape - Feb 01, 2011.

Table 1. General Overview of Immunosuppressive Agents for Renal Transplantation^{17,18,20,22,51}
Drug	Labeled for Induction	Common I.V. Dosage	Common Adverse Effects	Average Wholesale Price per Course of Therapy^a
Alemtuzumab	No	20–30 mg × 1–2 doses	Flulike symptoms, chills, rigors, fever, rash, myelosuppression	$1,926.82–$3,853.64
Antithymocyte globulin (equine)	Yes	15 mg/kg × 3–14 days	Flulike symptoms, chills, rigors, fever, rash, myelosuppression	$30,723–$143,377.92
Antithymocyte globulin (rabbit)	No	1.5 mg/kg × 3–14 days	Flulike symptoms, chills, rigors, fever, rash, myelosuppression	$7,511.40–$35,053.20
Muromonab-CD3^b	No	5 mg × 7–14 days	Headache, hypertension, pulmonary edema, tremor, fever, aseptic meningitis	$8,750.14–$17,500.28
Daclizumab^b	Yes	1 mg/kg × 5 doses	Hyperglycemia (only after infusion)	$7,400.10
Basiliximab	Yes	20 mg × 2 doses	None compared with placebo	$4,084.04

^aFor 70-kg patient.
^bNo longer available in the United States.

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Induction Immunosuppressive Therapies in Renal Transplantation

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