Wang Kun, Xu Xianlin, Fan Min
Department of Surgical Urology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.
Department of Surgical Urology, Sir Run Run Hospital, Nan Jing Medical University, Nanjing, 211100, Jiangsu, China.
Clin Exp Nephrol. 2018 Jun;22(3):684-693. doi: 10.1007/s10157-017-1480-z. Epub 2017 Oct 6.
The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft.
Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4.1 software were used for the meta-analysis.
Eight RCTs were included, including a total of 1153 patients. Of these, 547 (47%) had received basiliximab, and 606 (53%) had received ATG. The pooled results revealed that the basiliximab had a lower rate of neoplasm compared with ATG [odds ratio (OR) 0.26; 95% confidence interval (CI) 0.08-0.78; P = 0.02]. There were no significant differences between the two drugs regarding 1-year acute rejection rate (OR 1.32; 95% CI 0.93-1.87; P = 0.13), 1-year graft survival rate (OR 0.73; 95% CI 0.45-1.18; P = 0.20), 1-year patient survival rate (OR 0.52; 95% CI 0.27-1.02; P = 0.06), 1-year infection rate (OR 0.90; 95% CI 0.48-1.68; P = 0.73).
Induction therapy of basiliximab has similar short-time effects on the recipients in renal transplantation compared with that of ATG. However, regarding the long-term effect, as represented by the rate of neoplasm, basiliximab has a significant advantage.
本荟萃分析旨在评估巴利昔单抗与抗胸腺细胞球蛋白在肾移植诱导治疗中的疗效。
检索Medline（PubMed）、Embase、Ovid、Cochrane和中国生物医学文献数据库，以确定比较巴利昔单抗与抗胸腺细胞球蛋白（ATG）用于肾移植诱导治疗的前瞻性随机对照试验。使用RevMan 5.1软件和Stat Manager V4.1软件进行荟萃分析。
纳入8项随机对照试验，共1153例患者。其中，547例（47%）接受了巴利昔单抗治疗，606例（53%）接受了ATG治疗。汇总结果显示，与ATG相比，巴利昔单抗的肿瘤发生率较低[比值比（OR）0.26；95%置信区间（CI）0.08 - 0.78；P = 0.02]。两种药物在1年急性排斥反应率（OR 1.32；95% CI 0.93 - 1.87；P = 0.13）、1年移植肾存活率（OR 0.73；95% CI 0.45 - 1.18；P = 0.20）、1年患者存活率（OR 0.52；95% CI 0.27 - 1.02；P = 0.06）、1年感染率（OR 0.90；95% CI 0.48 - 1.68；P = 0.73）方面无显著差异。
在肾移植中，巴利昔单抗的诱导治疗与ATG相比，对受者的短期效果相似。然而，以肿瘤发生率为代表的长期效果方面，巴利昔单抗具有显著优势。
